Percutaneous coronary intervention in octogenarians: 10-year experience from a primary percutaneous coronary intervention centre with off-site cardiothoracic support
Joanna Abramik1
Amardeep Dastidar2
Nestoras Kontogiannis1
Victoria North1
Gopendu Patri1
Nicholas Weight1
Tushar Raina1
George Kassimis3
1.Cheltenham General Hospital,Gloucestershire Hospitals NHS Foundation Trust,Cheltenham,United Kingdom2.Bristol Heart Institute,University Hospitals NHS Foundation Trust,Bristol,United Kingdom3.Cheltenham General Hospital,Gloucestershire Hospitals NHS Foundation Trust,Cheltenham,United Kingdom;Second Department of Cardiology,Hippokration Hospital,Medical School,Aristotle University of Thessaloniki,Thessaloniki,Greece
摘要：OBJECTIVE To examine the trends in patient characteristics and clinical outcomes over a ten-year period and to analyse the predictors of mortality in octogenarians undergoing percutaneous coronary intervention (PCI) in our centre. METHODS A total of 782 consecutive octogenarians (aged 80 and above) were identified from a prospectively collected PCI database within our non-surgical, medium volume centre between 1st January 2007 and 31st December 2016. This represented 10.9％ of all PCI procedures performed in our centre during this period. We evaluated the demographic and procedural character-istics of the cohort with respect to clinical outcomes (all-cause in-hospital and 1-year mortality, in-hospital complication rates, duration of hospital admission, coronary disease angiographic complexity and major co-morbidities). The cohort was further stratified into three chronological tertiles (January 2007 to July 2012, 261 cases; August 2012 to May 2015, 261 cases; June 2015 to December 2016, 260 cases) to assess for differences over time. Predictors of mortality were identified through a multivariate re-gression analysis. RESULTS The number of octogenarians undergoing PCI increased nearly ten-fold over the studied period. Despite this, there were no significant differences in clinical outcomes or patient characteristics, except for the increased use of trans-radial vascular access [11.9％ in first tertile vs. 73.2％ in third tertile (P < 0.0001)]. The all-cause in-hospital (5.8％ vs. 4.6％ vs. 3.8％, P = 0.578) and 1-year mortality (12.4％ vs. 12.5％ vs. 14.4％, P = 0.746) remained constant in all three tertiles respectively. Six independent predict-ors of mortality were identified - increasing age [HR = 1.12 (1.03?1.22), P = 0.008], cardiogenic shock [HR = 16.40 (4.04–66.65), P <0.0001], severe left ventricular impairment [HR = 3.52 (1.69?7.33), P = 0.001], peripheral vascular disease [HR = 2.73 (1.22?6.13), P =0.015], diabetes [HR = 2.59 (1.30?5.17), P = 0.007] and low creatinine clearance [HR = 0.98 (0.96?1.00), P = 0.031]. CONCLUSION This contemporary observational study provides a useful insight into the real-world practice of PCI in octogen-arians.
机标关键词：percutaneouswithfrom10-yearcardiothoraciccentrecoronaryexperience
论文发表日期：2022-03-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 189-197 )