Success rate, procedural complications and clinical outcomes of coronary interventions in octogenarians: a case-control study.

BACKGROUND

Clinical trials of revascularization have routinely under-enrolled elderly subjects. Thus, symptom relief and improved survival might not apply to elderly patients, in whom the risk of mortality and disability from revascularization procedures seems to be high and co-morbidity is more prevalent. The present case control study was performed to draw a comparison in terms of the procedural success, procedural and in-hospital complications, and major adverse cardiac events (MACE) in a one-year follow-up of octogenarians (age ≥ 80 years) with a selected matched younger control group in the Tehran Heart Center Angioplasty Registry.

METHODS

According to the Tehran Heart Center Interventional Registry of 9, 250 patients with a minimum follow-up period of one year between April 1993 and February 2010, 157 percutaneous coronary intervention (PCI) procedures were performed in 112 octogenarians. Additionally, 336 younger patients (459 PCI procedures) were selected from the database as the propensity-score matched controls.

RESULTS

There were 147 (93.6%) and 441 (96.1%) successful PCI procedures in the elderly group and control group, respectively (p value = 0.204). Procedural complications were seen in 5 (3.2%) of the elderly group and 16 (3.5%) of the control group (p value = 0.858). Totally, 7 (6.3%) in-hospital complications occurred in the elderly group and 22 (6.8%) in the control group (p value = 0.866). One-year MACE was seen in 9 (9.1%) of the elderly and 18 (5.8%) of the control group (p value = 0.26).

CONCLUSION

Procedural success and complications, in-hospital complications, and one-year MACE were not significantly different between our two study groups. Therefore, age alone should not be used as the sole criterion when considering revascularization procedures. Furthermore, PCI should not be refused in octogenarians if indicated.