Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 24;1(5):100442.
doi: 10.1016/j.jscai.2022.100442. eCollection 2022 Sep-Oct.

Prognosis of PCI in the Older Adult Population: Outcomes From the Multicenter Prospective e-ULTIMASTER Registry

Majdi Saada  1 , Ofer Kobo  1 , Floris Kauer  2 , Orazbek Sakhov  3 , Peep Laanmets  4 , Rajpal Abhaichand  5 , Iñigo Lozano  6 , Jim Crowley  7 , Gurupreet Singh Wander  8 , Mamas A Mamas  9 , Ariel Roguin  1 ; e-ULTIMASTER Investigators
Affiliations

Prognosis of PCI in the Older Adult Population: Outcomes From the Multicenter Prospective e-ULTIMASTER Registry

Majdi Saada et al. J Soc Cardiovasc Angiogr Interv. .

Abstract

Background: Older adult patients undergoing percutaneous coronary intervention (PCI) are usually excluded from clinical trials. This study aimed to assess 1-year clinical outcomes in patients aged >80 years.

Methods: This all-comer registry included patients who underwent PCI using the Ultimaster stent. Primary clinical endpoint was target lesion failure (TLF), a composite of cardiac death (CD), target vessel-related myocardial infarction (TV-MI), or clinically indicated target lesion revascularization (CD-TLR).

Results: In total, 3286 (8.8%) patients aged ≥80 years were compared with 33,912 patients aged <80 years. The older adult patients included more women, had more comorbidities and exhibited more complex coronary anatomy. The incidence of TLF was higher in the older adult group (5.6% vs 3.0%, P < .0001), as well as for all-cause mortality (6.2% vs 1.7%, P < .0001), CD (3.3% vs 1.1%, P < .0001), and TV-MI (1.7% vs 0.8%, P < .0001), but not for CD-TLR (1.9% vs 1.7%, P = .15). After the inverse propensity score weighted analysis, aged ≥80 years was associated with increased risk of TLF (HR, 1.42; 95% CI, 1.22-1.66; P < .0001), CD (HR, 1.67; 95% CI, 1.136-2.06; P < .0001), and TV-MI (HR, 1.66; 95% CI, 1.24-2.24; P < .001) but not for CD-TLR (HR, 1.10; 95% CI, 0.85-1.43; P = .45).

Conclusion: Older adult patients had a higher incidence of TLF, CD, and TV-MI but with no difference in the incidence of recurrent revascularization or stent thrombosis. Although PCI in older adults is relatively safe, higher rates of cardiac events should be considered.

Keywords: age; coronary artery disease; elderly; older adults; outcome; stent; vascular disease.

PubMed Disclaimer

Figures

None
Cardiac event rates after PCI.
Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Outcome after propensity score adjustment. Kaplan–Meier cumulative incidence of event curves after inverse-weighted propensity score adjustment: target lesion failure (A), cardiac death, (B) target vessel–related myocardial infarction, (C) and clinically driven target lesion revascularization (D).
Figure 3
Figure 3
Cumulative event rates after propensity score adjustment at 1-year showing higher event rates for the older adult group except for the revascularizations. CD-TVR, clinically driven target vessel revascularization; CD-TLR, clinically driven target lesion revascularization; MI, myocardial infarction; TV-MI, target vessel–related myocardial infarction; ST, stent thrombosis (definite/probable).
Central Illustration
Central Illustration
Cardiac event rates in older adults (≥80 years) after PCI. Older adults had a higher incidence of target lesion failure, cardiac death, target vessel myocardial infarction, but not for target lesion revascularization.
Supplementary Figure 1
Supplementary Figure 1
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Tsounis D., Deftereos S., Bouras G., et al. High sensitivity troponin in cardiovascular disease. Is there more than a marker of myocardial death? Curr Top Med Chem. 2013;13(2):201–215. - PubMed
    1. Renilla A., Barreiro M., Barriales V., Torres F., Alvarez P., Lambert J.L. Management and risk factors for mortality in very elderly patients with acute myocardial infarction. Geriatr Gerontol Int. 2013;13(1):146–151. - PubMed
    1. Trucil D.E., Lundebjerg N.E., Busso D.S. RESEARCH When it comes to older adults, language matters and is changing: American Geriatrics Society update on reframing aging style changes. J Am Geriatr Soc. 2021;69(1):265–267. - PubMed
    1. Parikh R., Chennareddy S., Debari V., et al. Percutaneous coronary interventions in nonagenarians: in-hospital mortality and outcome at one year follow-up. Clin Cardiol. 2009;32(12):E16–E21. - PMC - PubMed
    1. Sawant A.C., Josey K., Plomondon M.E., et al. Temporal trends, complications, and predictors of outcomes among nonagenarians undergoing percutaneous coronary intervention: insights from the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program. JACC Cardiovasc Interv. 2017;10(13):1295–1303. - PubMed

LinkOut - more resources