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Research Article
 
DOI:10.11909/j.issn.1671-5411.2017.10.005
Bleeding outcomes after non-emergency percutaneous coronary intervention in the very elderly
Vimalraj Bogana Shanmugam,Dennis T Wong,Hashrul Rashid,James D Cameron,Yuvaraj Malaiapan,Peter J Psaltis.Bleeding outcomes after non-emergency percutaneous coronary intervention in the very elderlyJ Geriatr Cardiol 2017,14(10):624~631
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Authors:Vimalraj Bogana Shanmugam1;Dennis T Wong1;Hashrul Rashid1;James D Cameron1;Yuvaraj Malaiapan1;Peter J Psaltis2

Author Affiliation:1.Monash Cardiovascular Research Centre, Clayton Campus of Monash University, Victoria, Australia;2.South Australian Health and Medical Research Institute, Adelaide, Australia

Foundation:

Abstract: Background Octogenarians constitute an increasing proportion of patients presenting for non-emergency percutaneous coronary intervention (PCI). Methods This study evaluated the in-hospital procedural characteristics and outcomes, including the bleeding events of 293 octogenarians presenting between January 2010 and December 2012 for non-emergency PCI to a single large volume tertiary care Australian center. Comparisons were made with 293 consecutive patients aged less than or equal to 60 years, whose lesions were matched with the octogenarians. Results Non-ST elevation myocardial infarction was the most frequent indication for non-emergency PCI in octogenarians. Compared to the younger cohort, they had a higher prevalence of co-morbidities and more complex coronary disease, comprising more type C and calcified lesions. Peri-procedural use of low molecular weight heparin (LMWH; 1.0% vs. 5.8%; P < 0.001) and glycoprotein IIb/IIIa inhibitors (2.1% vs. 9.6%; P < 0.001) was lower, while femoral arterial access was used more commonly than in younger patients (80.9% vs. 67.6%; P < 0.001). Overall, there was a non-significant trend towards higher incidence of all bleeding events in the elderly (9.2% vs. 5.8%; P = 0.12). There was no significant difference in access site or non-access site bleeding and major or minor bleeding between the two cohorts. Sub-analysis did not reveal any significant influence on bleeding rates by the use of LMWH, glycoprotein IIb/IIIa inhibitors or femoral arterial access. In addition, there were no significant differences in the rates of in-hospital mortality, stroke or acute stent thrombosis between the two groups. Conclusions In this single center study, we did not observe significant increases in adverse in-hospital outcomes including the incidence of bleeding in octogenarians undergoing non-emergency PCI.

Keywords:

Bleeding; Coronary artery disease; Octogenarians; Percutaneous coronary intervention
Received:June 14, 2017        Accepted:October 24, 2017   Published Online:October 28, 2017
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