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Title: | Bleeding outcomes after non-emergency percutaneous coronary intervention in the very elderly. | Authors: | Malaiapan Y.;Shanmugam V.B.;Psaltis P.J.;Wong D.T.;Rashid H.;Cameron J.D. | Institution: | (Shanmugam, Wong, Rashid, Cameron, Malaiapan) Monash Cardiovascular Research Centre, Clayton Campus of Monash University, Monash University and Monash Health, 246 Clayton Rd, Clayton, VIC 3168, Australia (Psaltis) South Australian Health and Medical Research Institute, Adelaide, Australia | Issue Date: | 21-Dec-2017 | Copyright year: | 2017 | Publisher: | Science Press (E-mail: shengtaixuebao@mail.rcees.ac.cn) | Place of publication: | China | Publication information: | Journal of Geriatric Cardiology. 14 (10) (pp 624-631), 2017. Date of Publication: 2017. | Journal: | Journal of Geriatric Cardiology | 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.Copyright ©2017 JGC All rights reserved. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.11909/j.issn.1671-5411.2017.10.005 | Link to associated publication: | Click here for full text options | ISSN: | 1671-5411 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/38753 | Type: | Article | Subjects: | hospital mortality human major clinical study male middle aged non ST segment elevation myocardial infarction *percutaneous coronary intervention prevalence retrospective study stent thrombosis tertiary health care treatment indication very elderly fibrinogen receptor antagonist/dt [Drug Therapy] low molecular weight heparin/dt [Drug Therapy] incidence adult aged article Australia *bleeding/co [Complication] *bleeding/dt [Drug Therapy] bleeding/dt [Drug Therapy] bleeding time cardiovascular risk cerebrovascular accident clinical feature clinical outcome comorbidity controlled study coronary artery disease disease severity female femoral artery comorbidity controlled study coronary artery disease disease severity female femoral artery hospital mortality human incidence major clinical study male middle aged non ST segment elevation myocardial infarction *percutaneous coronary intervention prevalence retrospective study stent thrombosis tertiary health care treatment indication Australia Article aged adult very elderly *bleeding / *complication / *drug therapy bleeding / drug therapy bleeding time cardiovascular risk cerebrovascular accident clinical feature clinical outcome |
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