Keele Cardiovascular Research Group, Centre for Prognosis Research, Institutes of Applied Clinical Science and Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.
Royal Stoke University Hospital, Stoke-on-Trent, UK.
Catheter Cardiovasc Interv. 2022 Nov;100(5):711-720. doi: 10.1002/ccd.30366. Epub 2022 Sep 2.
Complex, high-risk percutaneous coronary intervention (PCI) (CHiP) is increasingly being undertaken in octogenarians. However, limited data exist on CHiP types, trends, and outcomes in the octogenarian.
This is a retrospective cohort study from a national registry dataset on CHiP undertaken in patients with stable angina in England and Wales (January 2006 and December 2017) according to three age groups (group 1 [G1]: < 65 years; group 2 [G2]: 65-79 years; and group 3 [G3]: ≥80 years).
Of 424,290 elective PCI procedures, 138,831 (33.0%) were CHiP [G1: 46,832 (33.7%); G2: 59,544 (42.9%); G3: 32,455 (23.4%)]. Among CHiP types, chronic total occlusion (CTO) (49.2%), prior coronary artery bypass graft (CABG) (30.4%), and severe vascular calcification (21.8%) were common in G1; prior CABG (42.9%), CTO (32.9%), and severe vascular calcifications (27%) were common in G2; prior CABG (15.8%), severe vascular calcification (15.5%), and chronic renal failure (11.1%) were common CHiP among the octogenarians. The older age groups had higher adjusted odds (aOR) for adverse outcomes [G2: mortality, aOR 1.7, 95% confidence interval (CI): (1.3-2.3); major bleeding, aOR 1.3, 95% CI (1.1-1.5); MACCE, aOR 1.2, 95% CI (1.0-1.3); G3: mortality, aOR 2.6, 95%CI (1.9-3.6); major bleeding, aOR 1.4, 95% CI (1.1-1.7); MACCE, aOR 1.3, 95% CI (1.1-1.5)].
There were significant differences in the types of CHiP cases undertaken and clinical outcomes across age groups.
复杂、高危经皮冠状动脉介入治疗（PCI）（CHiP）在 80 岁以上患者中越来越常见。然而，关于 80 岁以上患者的 CHiP 类型、趋势和结果的数据有限。
这是一项回顾性队列研究，来自英国和威尔士的全国性 CHiP 登记数据集（2006 年 1 月至 2017 年 12 月），根据年龄分为三组（第 1 组 [G1]：<65 岁；第 2 组 [G2]：65-79 岁；第 3 组 [G3]：≥80 岁）。
在 424290 例选择性 PCI 手术中，138831 例（33.0%）为 CHiP [G1：46832 例（33.7%）；G2：59544 例（42.9%）；G3：32455 例（23.4%）]。在 CHiP 类型中，慢性完全闭塞（CTO）（49.2%）、既往冠状动脉旁路移植术（CABG）（30.4%）和严重血管钙化（21.8%）在 G1 中常见；既往 CABG（42.9%）、CTO（32.9%）和严重血管钙化（27%）在 G2 中常见；既往 CABG（15.8%）、严重血管钙化（15.5%）和慢性肾功能衰竭（11.1%）在 80 岁以上患者中常见。年龄较大的组发生不良结局的调整比值比（aOR）更高[G2：死亡率，aOR 1.7，95%置信区间（CI）：（1.3-2.3）；大出血，aOR 1.3，95%CI（1.1-1.5）；MACCE，aOR 1.2，95%CI（1.0-1.3）；G3：死亡率，aOR 2.6，95%CI（1.9-3.6）；大出血，aOR 1.4，95%CI（1.1-1.7）；MACCE，aOR 1.3，95%CI（1.1-1.5）]。
不同年龄组的 CHiP 病例类型和临床结局存在显著差异。
