One-year outcome after percutaneous coronary intervention in nonagenarians: Insights from the J-PCI OUTCOME registry

Kanichi Otowa, Shun Kohsaka, Mitsuaki Sawano, Shintaro Matsuura, Akio Chikata, Michiro Maruyama, Kazuo Usuda, Tetsu Watanabe, Hideki Ishii, Tetsuya Amano, Masato Nakamura, Yuji Ikari

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Nonagenarian patients who undergo percutaneous coronary intervention (PCI) are increasing, and a few previous studies have reported their long-term outcomes. However, differences in their long-term outcomes between generations remain unclear. This study aimed to investigate 1-year all-cause and cardiovascular (CV) mortality, and major adverse cardiovascular events (MACE; cardiovascular death, myocardial infarction, and stroke) of nonagenarian patients who underwent PCI compared with the other elder patients, using a nationwide registration system. Methods: The patient-level data registered between January 2017 and December 2017 was extracted from the J-PCI OUTCOME Registry endorsed by the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT). The one-year all-cause and cardiovascular (CV) mortality, MACE, and major bleeding events were identified. Results: Out of 40,722 patients over 60 years of age, 880 (2.1%) were nonagenarians. For nonagenarians, the 1-year mortality rate was substantial (13.5%). The MACE and CV death rates were also high (8.1%, and 6.8%, respectively) for nonagenarians, and these event rates were approximately 1.5 times higher in nonagenarians than octogenarians. Multivariate regression analysis showed that presentation with cardiogenic shock [hazard ratio (HR) 2.32; 95 confidence intervals (CI): 1.22–4.41], or cardiac arrest (HR 2.91; 90% CI: 1.28–6.62), and use of oral anticoagulants (HR 2.10; 90% CI: 1.07–4.12) were the predictors of 1-year MACE. Conclusions: Even in the contemporary era, nonagenarians who have undergone PCI still face a considerably increased risk for adverse cardiovascular events that reduces long-term survival. In addition to having poorer lesion characteristics, adverse events, including death, MACEs, and major bleeding, occurred 1.5 times more frequently in nonagenarians than in octogenarians.

Original languageEnglish
Pages (from-to)105-116
Number of pages12
JournalAmerican heart journal
Volume246
DOIs
Publication statusPublished - 2022 Apr
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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