An Evaluation of Octogenarians Undergoing Percutaneous Coronary Intervention from the Melbourne Interventional Group Registry

Objectives: The objective of this study was to evaluate the clinical characteristics and outcomes of octogenarians (> or =80 years of age) in a contemporary, multi-centre percutaneous coronary intervention (PCI) registry.

Background: Octogenarians are increasingly referred for PCI. This patient population frequently has significant comorbidities, which result in major therapeutic challenges.

Methods: The study population consisted of consecutive patients undergoing PCI in seven major Australian hospitals, who were treated over a 2-year period (2004-2005).

Results: Of 4,360 PCI's, 11.3% (n = 491) were performed in octogenarians and 88.7% (n = 3,869) in patients <80 years. Octogenarians (compared with patients <80 years of age) were more likely female and have greater comorbidities such as cerebrovascular disease, renal impairment, congestive heart failure, and chronic airway disease. Octogenarians more frequently presented with acute coronary syndromes and cardiogenic shock. Octogenarians had significantly increased 30-day (6.0 vs. 1.4%, P < 0.01) and 12-month mortality (8.4% vs. 2.5%, P < 0.01), and major adverse cardiac event rates [(MACE), 30 days 11.3% vs. 5.4%, P < 0.01 and 12-months 18.7% vs. 12.9%, P = 0.04]. Cardiogenic shock, ST-segment elevation myocardial infarction, chronic renal failure, and age > or =80 years were independent predictors of 12-month mortality.

Conclusions: Octogenarians comprise a significant cohort of patients undergoing PCI. Octogenarians have more comorbidities, and higher rates of mortality and MACE, mandating thorough clinical evaluation before acceptance for PCI.