Ratanapo Supawat, Sukonthasarn Apichard, Promlikitchai Pitha, Thongplung Kamonrat, Thakkinstian Ammarin, Sansanayudh Nakarin
Phramongkutklao Hospital, Bangkok, Thailand.
Bangkok Hospital Chiangmai, Chiangmai, Thailand.
BMJ Open. 2025 Apr 29;15(4):e086945. doi: 10.1136/bmjopen-2024-086945.
Due to the growing ageing population worldwide, more percutaneous coronary interventions (PCI) are being performed on elderly patients; however, current national data in Southeast Asian developing countries regarding patient characteristics, procedural details and PCI outcomes in elderly patients are insufficient.
Observational study.
Nationwide registry from 39 primary PCI facilities across Thailand.
Between May 2018 and August 2019, the Thai PCI registry enrolled a total of 22 741 patients who underwent PCI. We examined patient characteristics, PCI technique and in-hospital outcomes in octogenarians (≥80 years) and non-octogenarians (18-79 years).
There were 2099 patients (9.2%) over the age of 80. Octogenarians were at greater risk for atherosclerosis and calcified coronary lesions that required plaque modification and a higher risk of cardiogenic shock during presentation than non-octogenarians. The success rate of PCI in octogenarians was high (95.5%) and comparable to non-octogenarians (96%). The respective PCI failure rate in non-octogenarians and octogenarians was 4% and 4.5% (p=0.251). Octogenarians had a substantially greater incidence of periprocedural problems (5.6% vs 4.5%, p=0.011). PCI was linked with more than threefold increase in in-hospital mortality in octogenarians compared with non-octogenarians (7.67% vs 2.3%, p 0.001). Nonetheless, revascularisation with PCI in octogenarians increased the EQ-5D (European Quality of Life 5 Dimensions) score by 15.7 after PCI and before hospital discharge.
According to the Thai PCI registry, octogenarians had more complicated coronary anatomy, as well as higher procedural complications and mortality than non-octogenarians. Nonetheless, PCI in the octogenarian had a high success rate and potentially improved the patient's quality of life.
由于全球老龄化人口不断增加，老年患者接受经皮冠状动脉介入治疗（PCI）的数量越来越多；然而，东南亚发展中国家目前关于老年患者的患者特征、手术细节和PCI结果的全国性数据不足。
观察性研究。
来自泰国39个主要PCI机构的全国性登记处。
在2018年5月至2019年8月期间，泰国PCI登记处共纳入了22741例接受PCI的患者。我们研究了80岁及以上（≥80岁）和非80岁患者（18 - 79岁）的患者特征、PCI技术和住院结局。
有2099名患者（9.2%）年龄在80岁以上。与非80岁患者相比，80岁及以上患者发生动脉粥样硬化和需要斑块修饰的钙化冠状动脉病变的风险更高，就诊时发生心源性休克的风险也更高。80岁及以上患者的PCI成功率较高（95.5%），与非80岁患者（96%）相当。非80岁患者和80岁及以上患者的PCI失败率分别为4%和4.5%（p = 0.251）。80岁及以上患者围手术期问题的发生率显著更高（5.6%对4.5%，p = 0.011）。与非80岁患者相比，80岁及以上患者PCI导致的住院死亡率增加了三倍多（7.67%对2.3%，p < 0.001）。尽管如此，80岁及以上患者PCI再血管化使PCI后至出院前的EQ - 5D（欧洲生活质量5维度）评分提高了15.7。
根据泰国PCI登记处的数据，80岁及以上患者的冠状动脉解剖结构更复杂，手术并发症和死亡率也高于非80岁患者。尽管如此，80岁及以上患者的PCI成功率较高，并可能改善了患者的生活质量。
