Percutaneous coronary intervention in octogenarians:10-year experience from a primary percutaneous coronary intervention centre with off-site cardiothoracic support  

作　　者：Joanna Abramik Amardeep Dastidar Nestoras Kontogiannis Victoria North Gopendu Patri Nicholas Weight Tushar Raina George Kassimis 

机构地区：[1]Cheltenham General Hospital,Gloucestershire Hospitals NHS Foundation Trust,Cheltenham,United Kingdom [2]Bristol Heart Institute,University Hospitals NHS Foundation Trust,Bristol,United Kingdom [3]Second Department of Cardiology,Hippokration Hospital,Medical School,Aristotle University of Thessaloniki,Thessaloniki,Greece

出　　处：《Journal of Geriatric Cardiology》2022年第3期189-197,共9页老年心脏病学杂志（英文版）

摘　　要：OBJECTIVE To examine the trends in patient characteristics and clinical outcomes over a ten-year period and to analyse the predictors of mortality in octogenarians undergoing percutaneous coronary intervention(PCI)in our centre.METHODS A total of 782 consecutive octogenarians(aged 80 and above)were identified from a prospectively collected PCI database within our non-surgical,medium volume centre between 1st January 2007 and 31st December 2016.This represented 10.9%of all PCI procedures performed in our centre during this period.We evaluated the demographic and procedural character-istics of the cohort with respect to clinical outcomes(all-cause in-hospital and 1-year mortality,in-hospital complication rates,duration of hospital admission,coronary disease angiographic complexity and major co-morbidities).The cohort was further stratified into three chronological tertiles(January 2007 to July 2012,261 cases;August 2012 to May 2015,261 cases;June 2015 to December 2016,260 cases)to assess for differences over time.Predictors of mortality were identified through a multivariate re-gression analysis.RESULTS The number of octogenarians undergoing PCI increased nearly ten-fold over the studied period.Despite this,there were no significant differences in clinical outcomes or patient characteristics,except for the increased use of trans-radial vascular access[11.9%in first tertile vs.73.2%in third tertile(P<0.0001)].The all-cause in-hospital(5.8%vs.4.6%vs.3.8%,P=0.578)and 1-year mortality(12.4%vs.12.5%vs.14.4%,P=0.746)remained constant in all three tertiles respectively.Six independent predict-ors of mortality were identified-increasing age[HR=1.12(1.03−1.22),P=0.008],cardiogenic shock[HR=16.40(4.04-66.65),P<0.0001],severe left ventricular impairment[HR=3.52(1.69−7.33),P=0.001],peripheral vascular disease[HR=2.73(1.22−6.13),P=0.015],diabetes[HR=2.59(1.30−5.17),P=0.007]and low creatinine clearance[HR=0.98(0.96−1.00),P=0.031].CONCLUSION This contemporary observational study provides a useful insight into the real-w

关 键 词：CORONARY MORTALITY cardio 

分 类 号：R541.4[医药卫生—心血管疾病]