Percutaneous coronary interventions in the elderly:a 10- year experience in Northern New England

Background There is a paucity of information available for clinical decision making applying to the elderly patient population. Therefore, data of percutaneous coronary interventions (PCI) including demographic information on the elderly patients, procedural practices, and outcomes are needed. Objectives and Methods From consec-utive PCIs of participating institutions, demographics data, clinical, angiographic success and adverse clinical out-comes were collected. Standard statistical methods were used to compare crude differences in patient and procedural characteristics across age groups. Results At baseline , the prevalence of comorbid conditions ( renal failure and heart failure) increased with age. Unstable angina or a non-ST elevation MI were the most common indications for PCI across all age groups . Fewer patients ^ 80 years old were undergoing primary PCI and older patients were some-what less likely to receive a lib/Ilia receptor blacker. Slightly more patients ^80 years old underwent a 2-vessel PCI ( consistent with them having more multivessel disease) and these patients were more likely to have an intervention on a Type C lesion . Compared to patients < 50 years old, those aged ^ 70 years old had a significantly increased risk of death , MI, stroke , or vascular complications at the access site . Conclusions This study suggests increasing age is associated with increasing risk for an adverse outcome following PCI. This is in part attributable to case-mix but likely, also related to the changing physiology of aging. Despite the increased risk of the procedure, the clinical suc-cess rate for PCI is quite high and makes it a reasonable alternative for the treatment of CAD in the elderly.