Comparison of Outcomes After Percutaneous Coronary Intervention in Elderly Patients, Including 10 628 Nonagenarians: Insights From a Japanese Nationwide Registry (J‐PCI Registry). Issue 5 (5th March 2019)

• Record Type: Journal Article
• Authors: Numasawa, Yohei; Inohara, Taku; Ishii, Hideki; Yamaji, Kyohei; Kohsaka, Shun; Sawano, Mitsuaki; Kodaira, Masaki; Uemura, Shiro; Kadota, Kazushige; Amano, Tetsuya; Nakamura, Masato
• Other Names: Kadota Kazushige investigator.; Shiode Nobuo investigator.; Tanaka Nobuhiro investigator.; Amano Tetsuya investigator.; Uemura Shiro investigator.; Akasaka Takashi investigator.; Morino Yoshihiro investigator.; Fujii Kenshi investigator.; Hikichi Hiroshi investigator.; Kohsaka Shun investigator.; Ishii Hideki investigator.; Tanabe Kengo investigator.; Ozaki Yukio investigator.; Sumitsuji Satoru investigator.; Iida Osamu investigator.; Hara Hidehiko investigator.; Takashima Hiroaki investigator.; Shirai Shinichi investigator.; Nanasato Mamoru investigator.; Inohara Taku investigator.; Ueda Yasunori investigator.; Numasawa Yohei investigator.; Noma Shigetaka investigator.
• Is Part Of: Journal of the American Heart Association. Volume 8:Issue 5(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-03-05
• Subjects: nonagenarians -- octogenarians -- percutaneous coronary intervention -- transradial intervention; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.118.011017
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: Scarce data exist about the outcomes after percutaneous coronary intervention (PCI) in old patients. This study sought to provide an overview of PCI in elderly patients, especially nonagenarians, in a Japanese large prospective nationwide registry. Methods and Results: We analyzed 562 640 patients undergoing PCI (≥60 years of age) from 1018 Japanese hospitals between 2014 and 2016 in the J‐PCI (Japanese percutaneous coronary intervention) registry. Among them, 10 628 patients (1.9%), including 6780 (1.2%) with acute coronary syndrome (ACS) and 3848 (0.7%) with stable coronary artery disease, were ≥90 years of age. We investigated differences in characteristics and in‐hospital outcomes among sexagenarians, septuagenarians, octogenarians, and nonagenarians. Older patients were more frequently women and had a greater frequency of heart failure and chronic kidney disease than younger patients. In addition, older patients had a higher rate of in‐hospital mortality, cardiac tamponade, cardiogenic shock after PCI, and bleeding complications requiring blood transfusion. Nonagenarians had the highest risk of in‐hospital mortality (odds ratio, 3.60; 95% CI, 3.10–4.18 in ACS; odds ratio, 6.24; 95% CI, 3.82–10.20 in non‐ACS) and bleeding complications (odds ratio, 1.79; 95% CI, 1.35–2.36 in ACS; odds ratio, 2.70; 95% CI, 1.68–4.35 in non‐ACS) when referenced to sexagenarians. More important, transradial intervention was an inverse independent predictor of both in‐hospital mortality and bleeding complications. Conclusions: Older patients, especially nonagenarians, carried a greater risk of in‐hospital death and bleeding compared with younger patients after PCI. Transradial intervention might contribute to risk reduction for periprocedural complications in elderly patients undergoing PCI.