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Comparative Study
. 2014 Mar;29(2):156-64.
doi: 10.1007/s00380-013-0339-9. Epub 2013 Apr 4.

Impact of aging on the clinical outcomes of Japanese patients with coronary artery disease after percutaneous coronary intervention

Hidehiro Kaneko  1 , Junji Yajima, Yuji Oikawa, Shingo Tanaka, Daisuke Fukamachi, Shinya Suzuki, Koichi Sagara, Takayuki Otsuka, Shunsuke Matsuno, Ryuichi Funada, Hiroto Kano, Tokuhisa Uejima, Akira Koike, Kazuyuki Nagashima, Hajime Kirigaya, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita
Affiliations
Comparative Study

Impact of aging on the clinical outcomes of Japanese patients with coronary artery disease after percutaneous coronary intervention

Hidehiro Kaneko et al. Heart Vessels. 2014 Mar.

Abstract

Japan has become an aging society, resulting in an increased prevalence of coronary artery disease. However, clinical outcomes of elderly Japanese patients after percutaneous coronary intervention (PCI) remain unclear. Of the 15,227 patients in the Shinken Database, a single-hospital-based cohort of new patients, 1,214 patients who underwent PCI, was evaluated to determine the differences in clinical outcomes between the elderly (≥75 years) (n = 260) and the non-elderly (<75 years) (n = 954) patients. A major adverse cardiac event (MACE) was defined as a composite end point, including all-cause death, myocardial infarction (MI), and target lesion revascularization. Male gender and obesity were less common, and the estimated glomerular filtration rate (eGFR) was significantly lower in the elderly than in the non-elderly. Left ventricular ejection fraction (LVEF) was comparable between these groups. Left main trunk disease and multivessel disease were more common in the elderly than in the non-elderly group. Occurrence of MACE was frequent, and the incidences of all-cause death, cardiac death, and the admission rate for heart failure were significantly higher in the elderly patients. Multivariate analysis showed that prior MI, low eGFR, and poor LVEF were independent predictors for all-cause death in the elderly patients. Elderly patients had worse clinical outcomes than the non-elderly patients. Low eGFR and LVEF were independent predictors of all-cause death after PCI, suggesting that left ventricular dysfunction and renal dysfunction might synergistically contribute to the adverse clinical outcomes of the elderly patients undergoing PCI.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for survival rates without major adverse cardiac events (MACE) (a), all-cause death (b), cardiac death (c), myocardial infarction (MI) (d), admission for heart failure (e), and target lesion revascularization (TLR) (f). Solid line elderly patients, dotted line non-elderly patients
See this image and copyright information in PMC

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