Clinical characteristics,therapeutic strategies,and outcomes in el-derly patients on oral anticoagulant therapy undergoing percu-taneous coronary interventions:post-hoc analysis of the PERSEO Registry
Simona Minardi1
Salvatore De Rosa2
Nicolò Salvi3
Giuseppe Andò4
Giuseppe Talanas5
Claudio D'angelo4
Carolina Moretti6
Tiziano Maria Mazza3
Bernardo Cortese7
Giuseppe Musumeci8
Andrea Rubboli6
Alessandro Sciahbasi3
1.Division of Cardiology,Sant'Eugenio Hospital,Rome,Italy2.Department of Medical and Surgical Sciences,Magna Grae-cia University,Catanzaro,Italy3.Interventional Cardiology,Sandro Pertini Hospital,Rome,Italy4.Department of Clinic-al and Experimental Medicine,Cardiology Section,University of Messina,Messina,Italy5.Clinical and Interventional Car-diology,Sassari University Hospital,Sassari,Italy6.Department of Emergency,Internal Medicine and Cardiology,Division of Cardiology,S.Maria delle Croci Hospital,Ravenna,Italy7.University Hospitals Harrington Heart & Vascular Institute,Cleveland,USA8.Division of Cardiology,Azienda Ospedaliera Ordine Mauriziano di Torino,Turin,Italy
摘要：BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoag-ulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early tran-sitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.
METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical featur-es,therapeutic strategies,and outcomes of individuals aged ≥ 80 years and＜80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardi-ac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3-5],and clinically relevant bleeding(BARC type 2-5).
RESULTS Among the 1234 patients enrolled,31％of patients were aged ≥ 80 years(84±3 years,76％males).Compared to youn-ger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fi-brillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23％)co-mpared to younger patients(13％)(P＜0.0001).They experienced higher net adverse clinical events(38％vs.21％,P＜0.001),MAC-CE(24％vs.12％,P＜0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9％vs.6％,P=0.026),and clinic-ally relevant bleeding(21％vs.12％,P＜0.001)were significantly higher in elderly patients.
CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and blee-ding compared to younger patients despite a less aggressive antithrombotic therapy.
机标关键词：characteristicsstrategiesregistryanalysisclinicaloralanticoagulantcoronary
论文发表日期：2025-08-30
在线出版日期：2025-09-22（本平台首次上网日期，不代表文献的发表时间）
页数：8( 701-708 )