Efficacy and Safety of Percutaneous Coronary Intervention for Elderly Patients in the Second-Generation Drug-Eluting Stent Era: The SHINANO Registry

• Published in: Angiology Vol. 68; no. 8; pp. 688 - 697
• Main Authors: Miura, Takashi, Miyashita, Yusuke, Motoki, Hirohiko, Kobayashi, Hideki, Kobayashi, Masanori, Nakajima, Hiroyuki, Kimura, Hikaru, Akanuma, Hiroshi, Mawatari, Eiichiro, Sato, Toshio, Hotta, Shoji, Kamiyoshi, Yuichi, Maruyama, Takuya, Watanabe, Noboru, Eisawa, Takayuki, Aso, Shinichi, Hashizume, Naoto, Ebisawa, Soichiro, Ikeda, Uichi
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-09-2017
• Subjects: Aged; Aged, 80 and over; Combined Modality Therapy; Coronary Artery Disease - drug therapy; Coronary Artery Disease - surgery; Drug-Eluting Stents; Endpoint Determination; Female; Humans; Japan; Male; Patient Safety; Percutaneous Coronary Intervention; Prognosis; Prospective Studies; Registries; Treatment Outcome; Japan; coronary artery disease; percutaneous coronary intervention; elderly
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319716679341

Background:
We evaluated the 1-year outcomes of percutaneous coronary intervention (PCI) for elderly patients (aged ≥ 80 years) in the second-generation drug-eluting stent (DES) era.
Methods and Results:
Between August 2012 and July 2013, 1923 consecutive patients (mean age, 71 ± 11 years; ≥80 years, 23%; men, 77%) who underwent 2250 elective/urgent PCI procedures were enrolled in the Shinshu Prospective Multicenter Analysis for Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention registry. The primary end point was major adverse cardiovascular events (MACEs; cardiovascular death, myocardial infarction, and stroke) at 1 year. The 1-year incidence of MACEs, cardiac death, and stroke was significantly higher in elderly patients than in nonelderly patients (12.4% vs 5.3%, P < .0001; 7.8% vs 2.2%, P < .0001; and 2.8% vs 1.3%, P = .033, respectively). However, no significant difference in elective PCI procedures was detected. In elderly patients, the incidence of cardiac death and target lesion revascularization was significantly lower for DES than for non-DES (2.7% vs 10.5%, P = .0001 and 4.1% vs 8.6%, P = .029, respectively).
Conclusion:
Although elderly patients had a significantly poorer prognosis than younger patients, the adverse events rate was comparable in those patients who underwent elective PCI in the second-generation DES era.