2018 Volume 64 Issue 5 Pages 379-385
Objective: Corresponding to an increasingly aging society, percutaneous coronary intervention (PCI) has been performed in elderly patients for the past few decades. However, there is a few data regarding patients’ characteristics and clinical outcomes in the subset of patients.
Materials and Methods: We used database of patients aged 70 to 85 who underwent PCI at Juntendo University between 1985 and 2010. The patients were divided into three groups depending on the timing of PCI (between December, 1985 and December, 1997; plain old balloon angioplasty (POBA)-era; between January, 1998 and July, 2004; bare metal stents (BMS)-era, between August, 2004 and December, 2010; drug-eluting stents (DES)-era). The clinical outcome was a composite of all-cause death and acute coronary syndrome (ACS) within 3-year after PCI.
Results: A total of 1,070 patients (POBA-era; 184, BMS-era; 367 and DES-era; 519) were examined. Mean age and body mass index (BMI), the prevalence rates of diabetes, hypertension and dyslipidemia were higher in the DES-era. Lipid profiles were better and prescription rates of evidenced-based medicine were higher in the DES-era. Event-free survival rates for 3-year all-cause death and ACS was not different between the three groups. Univariable Cox regression analysis showed that hazard ratio for the clinical outcome was not statistically different between the DES- and POBA-era. A similar result was found between the BMS-era and POBA-era. Multivariable Cox regression analysis showed that higher BMI, statin-use, and higher left ventricular ejection fraction and estimated glomerular filtration rate were associated with reduction in long-term clinical outcomes.
Conclusions: Clinical outcomes following PCI were similar among the POBA-, BMS- and DES-eras, despite the higher risk profiles of the elderly patients in the current DES-era.
