Outcome of contemporary percutaneous coronary intervention in the elderly and the very elderly: Insights from the blue cross blue shield of michigan cardiovascular consortium

Michael P. Thomas, Mauro Moscucci, Dean E. Smith, Herb Aronow, David Share, Phillip Kraft, Hitinder S. Gurm

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: There is a paucity of data on the outcome of contemporary percutaneous coronary intervention (PCI) in the elderly. Accordingly, we assessed the impact of age on outcome of a large cohort of patients undergoing PCI in a regional collaborative registry. Hypothesis: Increasing age is associated with a higher incidence of procedural-related complications. Methods: We evaluated the outcome of 152373 patients who underwent PCI from 2003 to 2008 in the 31 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. The procedural outcomes of the cohort were compared by dividing patients into <70 years of age, 70 to 79 years, 80 to 84 years, 85 to 89 years, and ≥90 years. Results: Of the cohort, 64.64% were <70 years of age, 23.83% were 70 to 79 years, 7.85% were 80 to 84 years, 3.09% were 85 to 89 years, and 0.58% were 90 years or older. Increasing age was associated with an increase in all-cause in-hospital mortality, contrast-induced nephropathy, transfusion, stroke/transient ischemic attack, and vascular complications. The overall in-hospital mortality rate was 1.09% and increased from 0.67% in those younger than 70 years up to 5.44% in those 90 years old or greater. The mortality rate in patients over 80 years approached 12% to 15% for those with ST-segment myocardial infarction and 39% in cardiogenic shock patients. Conclusions: The proportion of elderly patients referred for PCI is increasing. Procedural complications increase with age, and patients presenting with unstable symptoms are at the highest risk.

Original languageEnglish
Pages (from-to)549-554
Number of pages6
JournalClinical Cardiology
Volume34
Issue number9
DOIs
StatePublished - Sep 1 2011

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Blue Cross Blue Shield Insurance Plans
Percutaneous Coronary Intervention
Hospital Mortality
Cardiogenic Shock
Mortality
Transient Ischemic Attack
Blood Vessels
Registries
Stroke
Myocardial Infarction
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Outcome of contemporary percutaneous coronary intervention in the elderly and the very elderly : Insights from the blue cross blue shield of michigan cardiovascular consortium. / Thomas, Michael P.; Moscucci, Mauro; Smith, Dean E.; Aronow, Herb; Share, David; Kraft, Phillip; Gurm, Hitinder S.

In: Clinical Cardiology, Vol. 34, No. 9, 01.09.2011, p. 549-554.

Research output: Contribution to journalArticle

Thomas, Michael P. ; Moscucci, Mauro ; Smith, Dean E. ; Aronow, Herb ; Share, David ; Kraft, Phillip ; Gurm, Hitinder S. / Outcome of contemporary percutaneous coronary intervention in the elderly and the very elderly : Insights from the blue cross blue shield of michigan cardiovascular consortium. In: Clinical Cardiology. 2011 ; Vol. 34, No. 9. pp. 549-554.
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abstract = "Background: There is a paucity of data on the outcome of contemporary percutaneous coronary intervention (PCI) in the elderly. Accordingly, we assessed the impact of age on outcome of a large cohort of patients undergoing PCI in a regional collaborative registry. Hypothesis: Increasing age is associated with a higher incidence of procedural-related complications. Methods: We evaluated the outcome of 152373 patients who underwent PCI from 2003 to 2008 in the 31 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. The procedural outcomes of the cohort were compared by dividing patients into <70 years of age, 70 to 79 years, 80 to 84 years, 85 to 89 years, and ≥90 years. Results: Of the cohort, 64.64{\%} were <70 years of age, 23.83{\%} were 70 to 79 years, 7.85{\%} were 80 to 84 years, 3.09{\%} were 85 to 89 years, and 0.58{\%} were 90 years or older. Increasing age was associated with an increase in all-cause in-hospital mortality, contrast-induced nephropathy, transfusion, stroke/transient ischemic attack, and vascular complications. The overall in-hospital mortality rate was 1.09{\%} and increased from 0.67{\%} in those younger than 70 years up to 5.44{\%} in those 90 years old or greater. The mortality rate in patients over 80 years approached 12{\%} to 15{\%} for those with ST-segment myocardial infarction and 39{\%} in cardiogenic shock patients. Conclusions: The proportion of elderly patients referred for PCI is increasing. Procedural complications increase with age, and patients presenting with unstable symptoms are at the highest risk.",
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