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, 05/09/2012
Sillano 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.Methods
- 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.