DOI: 10.1161/circ.148.suppl_1.15100 ISSN: 0009-7322

Abstract 15100: Long-Term Clinical Outcomes Following Percutaneous Coronary Intervention in the Super Elderly Patients Aged Over 90 Years

KOTARO TOKUDA, Akihito Tanaka, Toyoaki Murohara, Hideki Ishii, Naoki Yoshioka, Miho Tanaka, Hiroshi Tashiro, Naoki Shibata, shogo yamaguchi, makoto iwama, Luka Yoshida, Yosuke Tatami, Norio Umemoto, Yusuke Uemura, Teruhiro Sakaguchi, Yosuke Negishi
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Background: In aged society, percutaneous coronary intervention (PCI) for super-elderly patient is not rarely performed in clinical practice. However, data regarding the clinical features and outcomes among the population are still limited.

Aim: To investigate the patient characteristics and long-term clinical outcomes in nonagenarians who underwent PCI.

Methods: This was a multicenter observational study, enrolling 402 nonagenarian patients who underwent PCI across 10 hospitals between 2011 and 2020. This study included the patients presented with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). Clinical outcomes including the occurrence of all-cause and cardiac deaths were investigated.

Results: In overall 402 patients (mean age 91.9±2.0 years, 48.3% male), regarding coronary risk factors, 74.6% had hypertension, 25.4% diabetes mellitus, and 56.7% dyslipidemia. Majority of patients (77.9%) were ACS, mainly ST-segment elevation myocardial infarction (53.2%), and 22.1% CCS. During hospitalization [median 14 days (interquartile range, 6-25 days)], in-hospital death occurred in 12.4%. The rate was significantly higher in ACS patients than CCS patients (15.3% vs. 2.2%, p<0.001). The cause of death was mainly cardiac death (96.0%). The median follow-up period was 544 days (interquartile range, 72-1171 days). The estimated cumulative incidence rates of all-cause death were 24.3%, 39.5% and 60.4% at 1-year, 3-years, and 5-years respectively. The rates of cardiac death were 18.0%,26.5% and 39.2% at 1-year, 3-years, and 5-years, respectively. No significant difference was observed in the occurrence of all-cause death between the patients with ACS and CCS. Regarding causes of death after discharge, 44.1% were cardiac causes mostly account for heart failure and sudden death, and 55.9% were non-cardiac causes mainly account for infection and cancer.

Conclusion: This study highlights the clinical features and long-term clinical course of nonagenarian patients who underwent PCI in the real-world setting. The patients presented with ACS had higher rate of in-hospital death than CCS, and the cumulative mortality increased approximately linearly after discharge, regardless of ACS or CCS.

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