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Clinical Characteristics and Outcomes of Elderly Patients Undergoing Primary Percutaneous Coronary Intervention: An Observational Cohort Study Cover

Clinical Characteristics and Outcomes of Elderly Patients Undergoing Primary Percutaneous Coronary Intervention: An Observational Cohort Study

Global Heart
Volume 19 (2024): Issue 1
By: Ahmed Hassan,  Amr Yosry Emam,  Mohammed Thabet,  Ahmed Osman,  Khaled Ahmed Shams,  Mina Samir Labib and  Ahmed Elguindy  
Open Access
|Dec 2024
Figures & tables

Figures & Tables

Table 1A

Comparisons of demographic, clinical, and angiographic variables between elderly and the younger populations.

VARIABLESAGE GROUP ≥70 YEARS (N = 575)AGE GROUP <70 YEARS (N = 3052)P VALUE
Demographic and clinical variables
Women197 (34.3%)559 (18.3%)<0.001
Hypertension332 (57.7%)1248 (40.9%)<0.001
Diabetes mellitus277 (48.2%)1352 (44.3%)0.171
Current smoker233 (40.5%)1964 (64.4%)<0.001
History of previous revascularization33 (5.7%)198 (6.5%)0.285
Chronic kidney disease216 (37.6 %)250 (8.2%)<0.001
Killip class ≥II at presentation161 (28%)468 (15.3%)<0.001
Cardiogenic shock at presentation67 (11.7%)155 (5.1%)<0.001
Total Ischemic time (hours) Median, interquartile range6.4 (4.0–10)5.8 (3.7–9.2)0.007
Radial access349 (60.7%)2143 (70.2%)<0.001
Angiographic variables
Associated severe LM disease33 (5.7%)95 (3.1%)0.001
Proximal LAD culprit235 (40.9%)1158 (37.9%)0.77
Non proximal LAD culprit135 (23.5%)802 (26.3%)0.057
LCX lesion culprit82 (14.3%)516 (16.9%)0.204
RCA lesion culprit199 (34.6%)851 (27.9%)<0.001
Ramus lesion culprit6 (1%)22 (0.7%)0.431
Large thrombus burden92 (16.0%)578 (18.9%)0.194
Final TIMI flow 0 or 16 (1.0%)27 (0.9%)0.694
Other non-culprit vessel severe lesions232 (40.3%)936 (30.7%)<0.001
Table 1B

Comparisons of demographic, clinical, and angiographic variables between the Octogenarians and Septuagenarians subgroups.

VARIABLESOCTOGENARIANS (≥80 YEARS)(N = 103)SEPTUAGENARIANS (AGE OF 70–79 YEARS)(N = 472)P VALUE
Demographic and clinical variables
Women32 (31.1%)165 (34.9%)0.493
Hypertension61 (59.2%)274 (58.05%)0.857
Diabetes mellitus48 (46.6%)232 (49.15%)0.790
Current smoker39 (37.9%)196 (41.5%)0.516
History of previous revascularization10 (9.7%)64 (13.6%)0.602
Chronic kidney disease57 (55.34 %)161 (34.11%)<0.001
Killip class ≥II at presentation33 (32.03%)128 (27.11%)0.334
Total-Ischemic time (hours) Median, interquartile range7 (4.5–10.6)6 (4.0–9.6)0.154
Angiographic variables
Severe LM disease10 (9.7%)23 (4.9%)0.072
Proximal LAD culprit38 (36.9%)197 (41.7%)0.582
Non proximal LAD culprit22 (21.4%)113 (23.9%)0.847
LCX lesion culprit17 (16.5%)65 (13.8%)0.759
RCA lesion culprit39 (37.9%)160 (33.9%)0.712
Ramus lesion culprit1 (1%)5 (1.1%)0.755
Large thrombus burden17 (16.5%)75 (15.9%)0.679
Final TIMI flow 0 or 12 (1.9%)4 (0.8%)0.077
Figure 1

Comparison of the incidence of in-hospital mortality between the three groups.

Table 2A

Comparison of in-hospital complications and outcomes between elderly and the younger populations.

VARIABLESAGE GROUP ≥70 YEARS (N= 575)AGE GROUP <70 YEARS (N= 3052)P VALUE
Contrast-induced nephropathy55 (9.6%)100 (3.3%)<0.001
Stroke3 (0.5%)9 (0.3%)0.581
TIMI major bleeding10 (1.7%)26 (0.9%)0.027
• Vascular access-related2 (20% of major bleeding)2 (7.7% of major bleeding)
• Non-Vascular access-related8 (80% of major bleeding)24 (92.3% of major bleeding)
Intracranial hemorrhage4 (0.7%)8 (0.3%)0.092
Acute and subacute Stent thrombosis6 (1.0%)13 (0.4%)0.036
In-hospital mortality81 (14.1%)122 (4%)<0.001
Table 2B

Comparisons of in-hospital complications and outcomes between Octogenarians and Septuagenarians subgroups.

VARIABLESOCTOGENARIANS (≥80 YEARS) (N = 103)SEPTUAGENARIANS (70–79 YEARS) (N = 472)PVALUE
Contrast-induced nephropathy13 (12.6%)42 (8.9%)0.267
Stroke1 (1%)2 (0.4%)0.149
TIMI major bleeding2 (1.9%)8 (1.7%)0.696
Intracranial hemorrhage1 (1%)3 (0.6%)0.629
Acute and subacute Stent thrombosis2 (1.9%)8 (1.7%)0.777
In hospital mortality24 (23.3%)57 (12.1%)0.005
Table 3A

Table 3A Predictors of in-hospital mortality among the Elderly cohort (multivariate analysis).

VARIABLESOR (95% CI)P VALUE
Sex0.915 (0.540–1.549)0.740
Age ≥ 80 years2.317 (1.303–4.120)0.004
Diabetes Mellitus1.608 (0.947–2.730)0.079
Hypertension1.550 (0.902–2.664)0.113
CKD0.991 (0.592–1.659)0.971
History of previous revascularization0.284 (0.062–1.297)0.104
Killip class ≥II at presentation4.568 (2.760–7.560)<0.001
Table 3B

Factors associated with in-hospital mortality stratified by age groups (multivariate analysis).

VARIABLESOCTOGENARIANS (≥80 YEARS) (n = 103)SEPTUAGENARIANS (70–79 YEARS) (n = 472)AGE GROUP <70 YEARS (n = 3052)
OR (95% CI)P valueOR (95% CI)P valueOR (95% CI)P value
Sex0.86 (0.269–2.79)0.8121.6 (0.75–3.3)0.261.42 (0.8–2.4)0.635
Diabetes Mellitus2.3 (0.820–6.73)0.1120.64 (0.33–1.4)0.171.87 (1.26–2.93)0.004
Hypertension1.1 (0.372–3.230)0.8680223–0.8430.140.94 (0.6–14)0.790
Current smoker1.6 (0.531–5.33)0.3730.370–1.2720.2310.87 (0.5–1.4)0.598
History of previous revascularization0.86 (0.297–45)0.3120.582–35.5030.1491.7 (0.7–40)0.234
Killip class ≥II at presentation6.57 (2.19–19.7)0.0010.136–0.4410.0017.4 (5–10.9)<0.001
Chronic kidney disease0.52 (0.181–1.56)0.2510.580–1.9790.8262.6 (1.6–4.1)<0.001
Table 4

Factors associated with TIMI major bleeding in the elderly (univariate analysis).

VARIABLESTIMI MAJOR BLEEDING (N = 10)NO TIMI MAJOR BLEEDING (N = 565)P VALUE
Age ≥ 80 years2 (20%)101 (17.9%)0.560
Female gender4 (40%)193 (34.2%)0.446
Hypertension7 (70%)325 (57.5%)0.539
Diabetes Mellitus6 (60%)271 (48%)0.541
CKD4 (40%)212 (37.5%)0.556
Glycoprotein IIb/IIIa inhibitors4 (40%)87 (15.4%)0.139
Femoral access9 (90%)217 (38.4%)0.001
DOI: https://doi.org/10.5334/gh.1383 | Journal eISSN: 2211-8179
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Language: English
Submitted on: Jun 9, 2024
Accepted on: Dec 5, 2024
Published on: Dec 30, 2024
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
primary percutaneous coronary intervention,
elderly,
septuagenarians,
octogenarians

© 2024 Ahmed Hassan, Amr Yosry Emam, Mohammed Thabet, Ahmed Osman, Khaled Ahmed Shams, Mina Samir Labib, Ahmed Elguindy, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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