Clinical characteristics and outcomes of percutaneous coronary intervention in octogenarians: real-world data from nationwide Thai PCI registry.

Abstract

Due to the growing ageing population worldwide, more percutaneous coronary interventions (PCI) are being performed on elderly patients; however, current national data in Southeast Asian developing countries regarding patient characteristics, procedural details and PCI outcomes in elderly patients are insufficient. Observational study. Nationwide registry from 39 primary PCI facilities across Thailand. Between May 2018 and August 2019, the Thai PCI registry enrolled a total of 22 741 patients who underwent PCI. We examined patient characteristics, PCI technique and in-hospital outcomes in octogenarians (≥80 years) and non-octogenarians (18-79 years). There were 2099 patients (9.2%) over the age of 80. Octogenarians were at greater risk for atherosclerosis and calcified coronary lesions that required plaque modification and a higher risk of cardiogenic shock during presentation than non-octogenarians. The success rate of PCI in octogenarians was high (95.5%) and comparable to non-octogenarians (96%). The respective PCI failure rate in non-octogenarians and octogenarians was 4% and 4.5% (p=0.251). Octogenarians had a substantially greater incidence of periprocedural problems (5.6% vs 4.5%, p=0.011). PCI was linked with more than threefold increase in in-hospital mortality in octogenarians compared with non-octogenarians (7.67% vs 2.3%, p 0.001). Nonetheless, revascularisation with PCI in octogenarians increased the EQ-5D (European Quality of Life 5 Dimensions) score by 15.7 after PCI and before hospital discharge. According to the Thai PCI registry, octogenarians had more complicated coronary anatomy, as well as higher procedural complications and mortality than non-octogenarians. Nonetheless, PCI in the octogenarian had a high success rate and potentially improved the patient's quality of life.