Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry

Objectives: To evaluate the effect of age in an all-comers population undergoing percutaneous coronary intervention (PCI). Background: Age is an important consideration in determining appropriateness for invasive cardiac assessment and perceived clinical outcomes. Methods: We analysed data from 29,0...

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Main Authors: Papapostolou, S., Dinh, D.T., Noaman, S., Biswas, S., Duffy, S.J., Stub, D., Shaw, J.A., Walton, A., Sharma, A., Brennan, A., Clark, D., Freeman, M., Yip, T., Ajani, A., Reid, Christopher, Oqueli, E., Chan, W.
Format: Journal Article
Language:English
Published: ELSEVIER SCIENCE INC 2021
Subjects:
Online Access:http://purl.org/au-research/grants/nhmrc/1111170
http://hdl.handle.net/20.500.11937/93762
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author Papapostolou, S.
Dinh, D.T.
Noaman, S.
Biswas, S.
Duffy, S.J.
Stub, D.
Shaw, J.A.
Walton, A.
Sharma, A.
Brennan, A.
Clark, D.
Freeman, M.
Yip, T.
Ajani, A.
Reid, Christopher
Oqueli, E.
Chan, W.
author_facet Papapostolou, S.
Dinh, D.T.
Noaman, S.
Biswas, S.
Duffy, S.J.
Stub, D.
Shaw, J.A.
Walton, A.
Sharma, A.
Brennan, A.
Clark, D.
Freeman, M.
Yip, T.
Ajani, A.
Reid, Christopher
Oqueli, E.
Chan, W.
author_sort Papapostolou, S.
building Curtin Institutional Repository
collection Online Access
description Objectives: To evaluate the effect of age in an all-comers population undergoing percutaneous coronary intervention (PCI). Background: Age is an important consideration in determining appropriateness for invasive cardiac assessment and perceived clinical outcomes. Methods: We analysed data from 29,012 consecutive patients undergoing PCI in the Melbourne Interventional Group (MIG) registry between 2005 and 2017. 25,730 patients <80 year old (78% male, mean age 62±10 years; non-elderly cohort) were compared to 3,282 patients ≥80 year old (61% male, mean age 84±3 years; elderly cohort). Results: The elderly cohort had greater prevalence of hypertension, diabetes and previous myocardial infarction (all p<0.001). Elderly patients were more likely to present with acute coronary syndromes, left ventricular ejection fraction <45% and chronic kidney disease (p<0.0001). In-hospital, 30-day and long-term all-cause mortality (over a median of 3.6 and 5.1 years for elderly and non-elderly cohorts, respectively) were higher in the elderly cohort (5.2% vs. 1.9%; 6.4% vs. 2.2%; and 43% vs. 14% respectively, all p<0.0001). In multivariate Cox regression analysis, estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 (HR 3.8, 95% CI: 3.4–4.3), cardiogenic shock (HR 3.0, 95% CI: 2.6–3.4), ejection fraction <30% (HR 2.5, 95% CI: 2.1–2.9); and age ≥80 years (HR 2.8, 95% CI: 2.6–3.1) were independent predictors of long-term all-cause mortality (all p<0.0001). Conclusion: The elderly cohort is a high-risk group of patients with increasing age being associated with poorer long-term mortality. Age, thus, should be an important consideration when individualising treatment in elderly patients.
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spelling curtin-20.500.11937-937622024-01-09T07:26:31Z Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry Papapostolou, S. Dinh, D.T. Noaman, S. Biswas, S. Duffy, S.J. Stub, D. Shaw, J.A. Walton, A. Sharma, A. Brennan, A. Clark, D. Freeman, M. Yip, T. Ajani, A. Reid, Christopher Oqueli, E. Chan, W. Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Elderly octogenarians Percutaneous coronary intervention Coronary angiography ELEVATION MYOCARDIAL-INFARCTION DRUG-ELUTING STENTS AMERICAN-HEART-ASSOCIATION LONG-TERM OUTCOMES ARTERY-DISEASE INCOMPLETE REVASCULARIZATION SCIENTIFIC STATEMENT CARDIOVASCULAR CARE GLOBAL REGISTRY BARE-METAL Coronary angiography Elderly octogenarians Percutaneous coronary intervention Aged Aged, 80 and over Australia Female Humans Male Middle Aged Percutaneous Coronary Intervention Registries Risk Factors Stroke Volume Ventricular Function, Left Melbourne Interventional Group Investigators Humans Stroke Volume Registries Risk Factors Ventricular Function, Left Aged Aged, 80 and over Middle Aged Australia Female Male Percutaneous Coronary Intervention Objectives: To evaluate the effect of age in an all-comers population undergoing percutaneous coronary intervention (PCI). Background: Age is an important consideration in determining appropriateness for invasive cardiac assessment and perceived clinical outcomes. Methods: We analysed data from 29,012 consecutive patients undergoing PCI in the Melbourne Interventional Group (MIG) registry between 2005 and 2017. 25,730 patients <80 year old (78% male, mean age 62±10 years; non-elderly cohort) were compared to 3,282 patients ≥80 year old (61% male, mean age 84±3 years; elderly cohort). Results: The elderly cohort had greater prevalence of hypertension, diabetes and previous myocardial infarction (all p<0.001). Elderly patients were more likely to present with acute coronary syndromes, left ventricular ejection fraction <45% and chronic kidney disease (p<0.0001). In-hospital, 30-day and long-term all-cause mortality (over a median of 3.6 and 5.1 years for elderly and non-elderly cohorts, respectively) were higher in the elderly cohort (5.2% vs. 1.9%; 6.4% vs. 2.2%; and 43% vs. 14% respectively, all p<0.0001). In multivariate Cox regression analysis, estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 (HR 3.8, 95% CI: 3.4–4.3), cardiogenic shock (HR 3.0, 95% CI: 2.6–3.4), ejection fraction <30% (HR 2.5, 95% CI: 2.1–2.9); and age ≥80 years (HR 2.8, 95% CI: 2.6–3.1) were independent predictors of long-term all-cause mortality (all p<0.0001). Conclusion: The elderly cohort is a high-risk group of patients with increasing age being associated with poorer long-term mortality. Age, thus, should be an important consideration when individualising treatment in elderly patients. 2021 Journal Article http://hdl.handle.net/20.500.11937/93762 10.1016/j.hlc.2020.12.003 English http://purl.org/au-research/grants/nhmrc/1111170 ELSEVIER SCIENCE INC restricted
spellingShingle Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Elderly octogenarians
Percutaneous coronary intervention
Coronary angiography
ELEVATION MYOCARDIAL-INFARCTION
DRUG-ELUTING STENTS
AMERICAN-HEART-ASSOCIATION
LONG-TERM OUTCOMES
ARTERY-DISEASE
INCOMPLETE REVASCULARIZATION
SCIENTIFIC STATEMENT
CARDIOVASCULAR CARE
GLOBAL REGISTRY
BARE-METAL
Coronary angiography
Elderly octogenarians
Percutaneous coronary intervention
Aged
Aged, 80 and over
Australia
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Registries
Risk Factors
Stroke Volume
Ventricular Function, Left
Melbourne Interventional Group Investigators
Humans
Stroke Volume
Registries
Risk Factors
Ventricular Function, Left
Aged
Aged, 80 and over
Middle Aged
Australia
Female
Male
Percutaneous Coronary Intervention
Papapostolou, S.
Dinh, D.T.
Noaman, S.
Biswas, S.
Duffy, S.J.
Stub, D.
Shaw, J.A.
Walton, A.
Sharma, A.
Brennan, A.
Clark, D.
Freeman, M.
Yip, T.
Ajani, A.
Reid, Christopher
Oqueli, E.
Chan, W.
Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry
title Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry
title_full Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry
title_fullStr Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry
title_full_unstemmed Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry
title_short Effect of Age on Clinical Outcomes in Elderly Patients (>80 Years) Undergoing Percutaneous Coronary Intervention : Insights From a Multi-Centre Australian PCI Registry
title_sort effect of age on clinical outcomes in elderly patients (>80 years) undergoing percutaneous coronary intervention : insights from a multi-centre australian pci registry
topic Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Elderly octogenarians
Percutaneous coronary intervention
Coronary angiography
ELEVATION MYOCARDIAL-INFARCTION
DRUG-ELUTING STENTS
AMERICAN-HEART-ASSOCIATION
LONG-TERM OUTCOMES
ARTERY-DISEASE
INCOMPLETE REVASCULARIZATION
SCIENTIFIC STATEMENT
CARDIOVASCULAR CARE
GLOBAL REGISTRY
BARE-METAL
Coronary angiography
Elderly octogenarians
Percutaneous coronary intervention
Aged
Aged, 80 and over
Australia
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Registries
Risk Factors
Stroke Volume
Ventricular Function, Left
Melbourne Interventional Group Investigators
Humans
Stroke Volume
Registries
Risk Factors
Ventricular Function, Left
Aged
Aged, 80 and over
Middle Aged
Australia
Female
Male
Percutaneous Coronary Intervention
url http://purl.org/au-research/grants/nhmrc/1111170
http://hdl.handle.net/20.500.11937/93762