Percutaneous Coronary Intervention in Very Elderly Patients. In-hospital Mortality and Clinical Outcome

Oqueli, Ernesto; Dick, Ron

doi:10.1016/j.hlc.2010.08.012

Cited by 15 publications

(14 citation statements)

References 24 publications

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“…Among 102 PCI performed for a variety of indications in very old patients, aged ≥ 85 years, there were 4 in-hospital deaths, all of them were patients presented to PCI due to acute STEMI. However, there were no deaths among very old patients from the same age group in whom PCI was indicated for stable coronary syndromes, post-STEMI, and other indications [93] .…”

Section: Different Indications Of Pci In Elderlymentioning

confidence: 94%

“…Many previous studies have demonstrated that older patients who underwent PCI for unstable ACS constituted the bigger portion of the total elderly underwent PCI. Among 102 CAD patients aged 85 years and older, PCI was indicated in an ACS setting in 72.6% of them and only 24.5% of PCIs were performed for patients with stable angina [93] . In another cohort, 93% of 177 PCI performed on nonagenarians were indicated in ACS settings and only 7% were elective PCI [41] .…”

Section: Different Indications Of Pci In Elderlymentioning

confidence: 99%

“…It is worth mentioning that clinical presentation and PCI indication are considered significant determinants of post-PCI clinical outcomes. As it has been shown that short and long-term clinical outcomes are usually superior in older patients who underwent PCI for stable CAD compared to unstable patients of the same age [93,94] . Among 102 PCI performed for a variety of indications in very old patients, aged ≥ 85 years, there were 4 in-hospital deaths, all of them were patients presented to PCI due to acute STEMI.…”

Section: Different Indications Of Pci In Elderlymentioning

confidence: 99%

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Percutaneous coronary intervention in the elderly: current updates and trends

Arisha¹,

Ibrahim²,

Abouarab³

et al. 2018

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Ischemic heart disease is the leading cause of death with acute coronary syndrome accounting for more than 30% of causes of mortality in the elderly population. The rate of growth of the older segment of the population has increased exponentially and will become more pronounced in the future. Historically, there has been a paucity of clinical trials investigating the challenges and outcomes of more invasive treatment strategies such as percutaneous coronary intervention (PCI) for that very segment of the population. However, the safety, efficacy, and outcomes of PCI in the older population have started to receive more attention, leading to some changes in their trends. There are several factors that make interventional cardiologists more resistant to direct the elderly to PCI. Most of these challenging factors, such as the complexity of coronary lesions, frailty, hematological and vascular changes, are discussed in this review. In addition. more advanced technologies have been introduced to PCI platform such as second-and thirdgenerations stents, several alternative approaches have been adopted like transradial approach and the usage of bivalirudin instead of heparin and GP IIb/IIIa inhibitor, and several imaging modalities have been optimized to assess patients' outcome and prognosis more accurately. Several recent studies have shown better results when these strategies are adopted. The most recent recommendations regarding performing PCI in the elderly are also discussed in this review.

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Section: Different Indications Of Pci In Elderlymentioning

confidence: 94%

Section: Different Indications Of Pci In Elderlymentioning

confidence: 99%

Section: Different Indications Of Pci In Elderlymentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous coronary intervention in the elderly: current updates and trends

Arisha¹,

Ibrahim²,

Abouarab³

et al. 2018

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“…The benefits of invasive management in the elderly have been replicated in multiple trials, with improved short‐term and long‐term outcomes . Despite these findings, patients aged >70 years are less likely to undergo coronary angiography than patients aged <70 years …”

Section: Invasive Managementmentioning

confidence: 99%

Many shades of grey: seeking the optimal medical therapy of acute coronary syndrome in older people

Paratz

Nicolaides

Layland

2017

Pharmacy Practice and Res

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Ischaemic heart disease is the leading cause of death worldwide. Age is the strongest risk factor, yet older patients are consistently underrepresented in clinical trials. With an ageing population, knowledge of the evidence base for the treatment of older patients with acute coronary syndrome (ACS) is crucial. As people age, their responses to medications change, and they may become more susceptible to adverse effects of cardiovascular medications. Management of ACS in older people may be further complicated by the presence of comorbidities, polypharmacy and frailty. Treatment decisions need to be individualised, with consideration of patient preferences, functional and cognitive status and life expectancy. This review aims to summarise the current data for the management of older patients with ACS, with a focus on pharmacological treatment.

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“…Similar to other studies, their presentation was more often an acute coronary syndrome, predominantly non-ST elevation MI. [14][15][16] The octogenarians had more severe coronary artery disease. Therefore, the lesions treated in this group were more difficult to treat, and required adjunctive medications and devices.…”

mentioning

confidence: 97%