Takashi Miura1, Yusuke Miyashita1, Hirohiko Motoki1, Hideki Kobayashi2, Masanori Kobayashi3, Hiroyuki Nakajima4, Hikaru Kimura5, Hiroshi Akanuma6, Eiichiro Mawatari7, Toshio Sato8, Shoji Hotta9, Yuichi Kamiyoshi10, Takuya Maruyama8, Noboru Watanabe11, Takayuki Eisawa12, Shinichi Aso10, Naoto Hashizume8, Soichiro Ebisawa1, Uichi Ikeda1. 1. 1 Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan. 2. 2 Department of Cardiology, Shinshu Ueda Medical Center, Ueda, Japan. 3. 3 Department of Cardiology, Matsumoto Kyoritsu Hospital, Matsumoto, Japan. 4. 4 Department of Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan. 5. 5 Department of Cardiology, Saku Central Hospital, Saku, Japan. 6. 6 Department of Cardiology, Iida Municipal Hospital, Iida, Japan. 7. 7 Department of Cardiology, Kita Alps Medical Center, Azumino, Japan. 8. 8 Department of Cardiology, Shinonoi General Hospital, Nagano, Japan. 9. 9 Department of Cardiology, Ina Central Hospital, Ina, Japan. 10. 10 Department of Cardiology, Aizawa Hospital, Matsumoto, Japan. 11. 11 Department of Cardiology, Hokushin General Hospital, Nakano, Japan. 12. 12 Department of Cardiology, Komoro Kosei General Hospital, Komoro, Japan.
Abstract
BACKGROUND: We evaluated the 1-year outcomes of percutaneous coronary intervention (PCI) for elderly patients (aged ≥ 80 years) in the second-generation drug-eluting stent (DES) era. METHODS AND RESULTS: Between August 2012 and July 2013, 1923 consecutive patients (mean age, 71 ± 11 years; ≥80 years, 23%; men, 77%) who underwent 2250 elective/urgent PCI procedures were enrolled in the Shinshu Prospective Multicenter Analysis for Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention registry. The primary end point was major adverse cardiovascular events (MACEs; cardiovascular death, myocardial infarction, and stroke) at 1 year. The 1-year incidence of MACEs, cardiac death, and stroke was significantly higher in elderly patients than in nonelderly patients (12.4% vs 5.3%, P < .0001; 7.8% vs 2.2%, P < .0001; and 2.8% vs 1.3%, P = .033, respectively). However, no significant difference in elective PCI procedures was detected. In elderly patients, the incidence of cardiac death and target lesion revascularization was significantly lower for DES than for non-DES (2.7% vs 10.5%, P = .0001 and 4.1% vs 8.6%, P = .029, respectively). CONCLUSION: Although elderly patients had a significantly poorer prognosis than younger patients, the adverse events rate was comparable in those patients who underwent elective PCI in the second-generation DES era.
BACKGROUND: We evaluated the 1-year outcomes of percutaneous coronary intervention (PCI) for elderly patients (aged ≥ 80 years) in the second-generation drug-eluting stent (DES) era. METHODS AND RESULTS: Between August 2012 and July 2013, 1923 consecutive patients (mean age, 71 ± 11 years; ≥80 years, 23%; men, 77%) who underwent 2250 elective/urgent PCI procedures were enrolled in the Shinshu Prospective Multicenter Analysis for Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention registry. The primary end point was major adverse cardiovascular events (MACEs; cardiovascular death, myocardial infarction, and stroke) at 1 year. The 1-year incidence of MACEs, cardiac death, and stroke was significantly higher in elderly patients than in nonelderly patients (12.4% vs 5.3%, P < .0001; 7.8% vs 2.2%, P < .0001; and 2.8% vs 1.3%, P = .033, respectively). However, no significant difference in elective PCI procedures was detected. In elderly patients, the incidence of cardiac death and target lesion revascularization was significantly lower for DES than for non-DES (2.7% vs 10.5%, P = .0001 and 4.1% vs 8.6%, P = .029, respectively). CONCLUSION: Although elderly patients had a significantly poorer prognosis than younger patients, the adverse events rate was comparable in those patients who underwent elective PCI in the second-generation DES era.