Percutaneous Coronary Intervention in Nonagenarians

Abstract

Background: Elderly people comprise the fast-growing segment of Taiwan’s population. We conducted a retrospective study to analyze the results of PCI in nonagenarians. Methods: 18 nonagenarians were enrolled. Six had medical management only (NM group) and 12 underwent PCI (NP group). Each patient in the NP group was matched with the next 4 consecutive patients (CP group, n = 48) younger than 90 years old and receiving PCI by the same operator. Results: The nonagenarian patients presented more chronic co-morbid diseases (p ＜ 0.001), acute coronary syndrome (p ＜ 0.001), and an LV ejection fraction ＜ 50% (p ＜ 0.001). Although the incidence of cardiac complications didn’t differ between the NP and CP groups, the NP group did have more non-cardiac complications (p = 0.015) and longer post-PCI length of stay (p = 0.038). Major adverse cardiac events (MACE) did not differ between NPand CPgroups in the subsequent 6 months of follow-up. Of note, the in-hospital mortality, MACE and all-cause mortality were higher in NMgroup than in the NPgroup (p = 0.025, 0.004 and 0.031, respectively). Using Cox multivariate proportional hazard regression model, only the presence of acute coronary syndrome and left ventricular ejection fraction ＜ 50% played a role in NM group vs. CP group (hazard ratio 3.42 and 3.07, p = 0.004 and 0.03, respectively), as well, the presence of acute coronary syndrome and diabetes mellitus played a significant role between the NP group and CP group (hazard ratios 2.41 and 2.09, p = 0.02 and 0.04, respectively). Conclusion: Although nonagenarians had a higher incidence of non-cardiac complications, PCI was technically successful and yielded an acceptable outcome.