A Retrospective multicentre observational study of the interventional management of coronary disease in the very elderly: The NINETY (NonagenarIaNs trEated by means of sTents studY)
Catheterization and Cardiovascular Interventions, 05/09/2012Sillano D et al.
Percutaneous coronary intervention (PCI) in nonagenarians is safe and feasible with acceptable major bleeding rates. However, long term results show high mortality rates particularly in the STEMI group.
All consecutive patients 90 years of age or older undergoing PCI with stent implantation between April 2002 and June 2009 were included in the study.
The primary end point was the long–term rate of net adverse cardiac events (NACE), that is, death, myocardial infarction (MI), target lesion revascularization (TLR) and life threatening or major bleedings.
146 nonagenarians were divided in three groups according to clinical setting: 27 (group A) stable angina or silent ischaemia, 85 (group B) unstable angina or Non–ST Elevation Myocardial Infarction and 34 (group C) with ST Elevation Myocardial Infarction.
At 30 days, the incidence of NACE was significantly lower in patients in Group A vs B or C (0% vs 17.3% vs 31.2% p=0.006) and the frequency of definite stent thrombosis was higher in Group C vs A or B (9.4% vs 0% vs 0%, p=0.007), respectively.
Up to a median follow–up of 24 months, NACE rate was 33.3% in group A, 49.3% in group B and 50% in group C (p=0.32).
There were no significant differences between groups in the individual components of the primary end–point.
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