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Tokuda K, Tanaka A, Uemura Y, Shibata N, Iwama M, Sakaguchi T, Yoshida R, Negishi Y, Tashiro H, Tanaka M, Tatami Y, Yamaguchi S, Yoshioka N, Umemoto N, Ohashi T, Takada Y, Asano H, Yoshida Y, Tanaka T, Noda T, Morishima I, Ishii H, Murohara T. Long-term clinical outcomes following percutaneous coronary intervention in patients aged 90 years and older. J Cardiol 2024:S0914-5087(24)00132-1. [PMID: 39034030 DOI: 10.1016/j.jjcc.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/18/2024] [Accepted: 07/08/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND In an aging society, percutaneous coronary intervention (PCI) for super-elderly patients is commonly performed in clinical practice. However, data are scarce regarding the clinical features and outcomes of this population. METHODS This multicenter observational study enrolled patients aged over 90 years who underwent PCI across 10 hospitals between 2011 and 2020. The study included patients presenting with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The occurrence of all-cause and cardiac deaths during hospitalization and after discharge was investigated. RESULTS In total, 402 patients (91.9 ± 2.0 years, 48.3 % male) participated in the study, of whom 77.9 % presented with ACS. The rate of in-hospital death was significantly higher in patients with ACS compared to patients with CCS (15.3 % vs. 2.2 %, p < 0.001). The estimated cumulative incidence rates of all-cause death were 24.3 %, 39.5 %, and 60.4 % at 1, 3, and 5 years, respectively. No significant difference was observed in the occurrence of all-cause death between patients with ACS and CCS. Regarding causes of death after discharge, non-cardiac deaths accounted for just over half of the cases. CONCLUSION This study highlights the clinical features and long-term clinical course of patients aged over 90 years who underwent PCI in a real-world setting. Patients presenting with ACS exhibited a higher rate of in-hospital mortality compared to those with CCS. Following discharge, both ACS and CCS patients experienced comparable and substantial increases in the incidence rates of both cardiac and non-cardiac mortality over time, and a more holistic management approach is warranted.
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Affiliation(s)
- Kotaro Tokuda
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihito Tanaka
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Yusuke Uemura
- Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan
| | - Naoki Shibata
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Makoto Iwama
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | | | - Ruka Yoshida
- Department of Cardiology, Japanese Red Cross Society Nagoya Daini Hospital, Nagoya, Japan
| | - Yosuke Negishi
- Department of Cardiology, Okazaki Municipal Hospital, Okazaki, Japan
| | - Hiroshi Tashiro
- Department of Cardiology, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Miho Tanaka
- Department of Cardiology, Konan Kosei Hospital, Konan, Japan
| | - Yosuke Tatami
- Department of Cardiology, Toyota Kosei Hospital, Toyota, Japan
| | | | - Naoki Yoshioka
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Norio Umemoto
- Department of Cardiology, Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Taiki Ohashi
- Department of Cardiology, Toyota Kosei Hospital, Toyota, Japan
| | - Yasunobu Takada
- Department of Cardiology, Konan Kosei Hospital, Konan, Japan
| | - Hiroshi Asano
- Department of Cardiology, Tosei General Hospital, Seto, Japan
| | - Yukihiko Yoshida
- Department of Cardiology, Japanese Red Cross Society Nagoya Daini Hospital, Nagoya, Japan
| | - Toshikazu Tanaka
- Department of Cardiology, Okazaki Municipal Hospital, Okazaki, Japan
| | - Toshiyuki Noda
- Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Itsuro Morishima
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Cardiology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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