Association of age with adverse events following coronary atherectomy during percutaneous coronary intervention
Dae Yong Park1
Jiun-Ruey Hu2
Sean DeAngelo3
Aviral Vij4
Yasser Jamil5
Golsa Babap-our1
Zafer Akman6
Parsa Pazooki7
Abdulla A.Damluji8
Jennifer Frampton DO1
Darri-ck K.Li9
Michael G.Nanna1
1.Section of Cardiovascular Medicine,Yale School of Medicine,New Haven,CT,USA2.Department of Cardiology,Smidt Heart Institute,Cedars-Sinai Medical Center,Los Angeles,CA,USA3.Department of Medicine,Cook County Health,Chicago,IL,USA4.Division of Cardiology,Cook County Health,Chicago,IL,USA5.Department of Cardi-ology,Inova Heart and Vascular Institute,Falls Church,VA,USA6.Department of Medicine,Yale School of Medicine,New Haven,CT,USA7.University of North Carolina at Chapel Hill School of Medicine,Chapel Hill,NC,USA8.Car-diovascular Center on Aging,Department of Cardiovascular Medicine,Cleveland Clinic Foundation,Cleveland,OH,USA.;Johns Hopkins University School of Medicine,Baltimore,Maryland,USA9.Section of Digestive Diseases,Yale School of Medicine,New Haven,CT,USA
摘要：Background Coronary atherectomy is used to treat severely calcified coronary artery lesions which are more frequent with in-creasing age,but its impact in older adults has not been sufficiently examined.
Methods We compared adults ≥ 18 years old who underwent coronary atherectomy during inpatient PCI in 2016-2023 from the Vizient Clinical Data Base and compared outcomes in younger(＜65 years),youngest-old(65-74 years),middle-old(75-84 years),and oldest-old(≥ 85 years)adults.Primary outcome was in-hospital mortality,and secondary outcomes included postpro-cedural complications.
Results Among 47,337 patients who underwent coronary atherectomy,19,862(42.0％)were younger adults and 27,475(58.0％)were older adults,including 13,583 youngest-old,10,206 middle-old,and 3,686 oldest-old adults.Compared with younger adults,youngest-old adults had higher mortality(adjusted odds ratio[aOR]=1.37,P＜0.001),ischemic stroke(aOR=1.35,P=0.005),gastrointestinal hemorrhage(GIH)(aOR=1.44,P＜0.001),acute kidney injury(AKI)(aOR=1.43,P＜0.001),tamponade(aOR=1.86,P＜0.001),and pericardiocentesis(aOR=2.32,P＜0.001).Middle-old adults had higher mortality(aOR=1.80,P＜0.001),GIH(aOR=1.42,P=0.002),AKI(aOR=1.63,P＜0.001),tamponade(aOR=2.52,P＜0.001),and pericardiocentesis(aOR=3.13,P＜0.001).Oldest-old adults had the highest odds for mortality(aOR=2.03,P＜0.001),GIH(aOR=1.48,P=0.016),AKI(aOR=2.26,P＜0.001),tamponade(aOR=3.86,P＜0.001),and pericardiocentesis(aOR=4.21,P＜0.001).There was a significant interac-tion(P-interaction=0.035)between atherectomy and age groups with regard to the odds of in-hospital mortality.
Conclusions In this large claims-based study,in-hospital mortality,GIH,AKI,tamponade,and pericardiocentesis were higher in older adults compared with younger adults,in a stepwise manner by age group.
机标关键词：associationpercutaneouswithadverseatherectomycoronaryduringevents
论文发表日期：2025-05-30
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( 497-505 )