Three-year Clinical Outcomes of Elective Percutaneous Coronary Interventions in Elderly Patients

Abstract

Background: Because of co-morbidities, shorter life expectancy, higher risk for complications, and poor clinical outcomes of percutaneous coronary intervention (PCI), the treatment strategy for the elderly is often conservative. The aim of this study was to evaluate long-term clinical outcomes of elective PCI in selected elderly patients with coronary artery disease and compare with young patients in real world scenario. Methods: The present study enrolled 1895 consecutive patients who underwent elective PCI from March 2003 to October 2007. The definition of elderly patient in this study was ≥ 75 yearold. Selected elderly patients (198 patients) who had more than 70 in Karnofsky score underwent elective PCI during study period. The outcomes of elderly group were compared to those of younger group (1697 patients) in the same period. The primary outcome is a composite of major adverse cardiac events (MACE) including cardiac death, myocardial infarction, and target vessel revascularization, 3 years after the index procedure. Results: The elderly group (77.9 ± 2.8 year-old) had more female gender (52.0% vs. 33.2%, p < 0.01), lesser smoker (19.7% vs. 37.2%, p < 0.01), and more acute coronary syndrome (67.9% vs. 59.4%, P = 0.04), than the young group (60.3 ± 9.3 year-old). However, there was no significant difference in MACE (6.5% in elderly vs. 7.1% in younger group, p = 0.81) 3 years after index procedure. Conclusions: Three-year clinical outcomes of elective PCI in selected elderly patients were acceptable, comparable to those of young patients.