Abstract 14697: Percutaneous Coronary Intervention in nonagenarians: Midterm Outcomes and Quality of Life assessment
PCI in Nonagenarians: Mid-term outcomes and Quality of Life assessment
Background: As the population ages, the number of nonagenarians is projected to increase at an unprecedented rate. A limited number of studies have demonstrated that these patients can be treated successfully with percutaneous coronary intervention (PCI). As these individuals continue to live longer, a greater number will require myocardial revascularization. However, mid-term clinical and functional benefits of PCI in this cohort of patients have not been clearly defined.
Methods: Between January 2005 and June 2009, 173 patients 90 years and older underwent diagnostic cardiac catheterization of which 93 patients had PCI. There were 48 males (52%) and 45 females (48%) with a mean age of 92.06 years (range: 90-101). Of these patients 24 (26%) presented with a STEMI, 32 (34%) patients with a Non-STEMI, 30 (32%)patients with unstable angina, 2 (2%) patients with stable angina, and 5 (5%) patients were studied for pre-operative risk assessment.
Results: A total of 127 lesions were successfully treated utilizing 102 drug eluting stents and 37 bare metal stents with a mean of 1.5 stents per patient. Post-procedure complications included renal insufficiency in 5 patients (5.6%), congestive heart failure in 6 patients (6.7%) and cardiogenic shock in 2 patients (2.2%). Seventy-seven patients (85.6%) experienced no post-procedure complications. The in-hospital mortality was 7.8% and the actuarial survival was 61.5% ± 5.2% at 24 months and 31.6% ± 6.1% at 48 months. The Short Form 36 Health Survey was administered at follow-up and results demonstrated a quality of life similar to that of the general population corrected for age and gender.
Conclusion: This study clearly demonstrates that PCI in nonagenarians can be accomplished with acceptable hospital mortality, morbidity and excellent mid-term results. Moreover, functional improvement in nonagenarians support an enhanced a quality of life comparable to that of the general population.
- © 2010 by American Heart Association, Inc.