Abstract 13475: Predictors of Long-Term Outcome of Percutaneous Coronary Intervention in Octogenarians with Acute Coronary Syndrome - A Retrospective Analysis
Background: The majority of patients with acute coronary syndrome are elderly. Limited scientific evidence makes decision-making on the use of percutaneous coronaryintervention(PCI) in this patient group mainly empirical. Old age is one risk factor for adverse outcome of PCI but other factors than age may have impact on mortality in this patient group. Objective: To identify predictors of all-cause long-term mortality among octogenarians undergone PCI and establish a score system identifying high-risk individuals in this patient group.
Methods and results: In a retrospective study data from 182patients ≥80years who have undergone PCI during 2006-2007 were consecutively included at Sahlgrenska University Hospital, Gothenburg, Sweden. 215 parameters covering social, functional and medical domains were entered into a database. Mean age was 83.7+2.8. Indications for PCI were STEMI (52%),NSTEMI (36%) and unstable angina (11%).All-cause mortality after 5 years follow up was 46.2%. Multivariate analysis of significant parameters from univariate analysis identified X-smoking, walking aid dependence, ADL dependence, incontinence, cognitive disorders, diabetes mellitus, atrial fibrillation, HR at admission >75 BPM, GFR >30ml/min, and CVP >10 mmHg as independent prognostic indicators. By establishing a score system based on multivariate analyses, we were able to separate this elderly patient cohort into 3 different risk levels with Kaplan Meier estimation: low-, intermediate- and high risk.
Conclusions:In an octogenarian patient cohort from daily clinical practice, by establishing a score system based on multivariate analysis, a low risk subgroup was dentified for probable gain from PCI in contrast to a high risk group that should be refrained from PCI.
- © 2012 by American Heart Association, Inc.