Predictors of Long-term Major Adverse Cardiac Events Following Percutaneous Coronary Intervention in the Elderly

Arch Iran Med. 2018 Aug 1;21(8):344-348.

Abstract

Background: We aimed to recognize the predictors of long-term major adverse cardiac events (MACE) in the elderly candidates for elective percutaneous coronary intervention (PCI) at our center.

Methods: In this retrospective cohort study, we reviewed the data of the elderly (age ≥65 years) candidates for elective PCI who met our study criteria, at Tehran heart center between 2004 and 2013. Demographic, anthropometric, clinical, angiographic, procedural and follow-up data of the enrolled patients were retrieved from the angiography/PCI databank of our center. The study characteristics of the patients with or without MACE were compared in a univariable Cox-regression analysis. A multivariable Cox-regression model was applied using variables selected from the univariable model to determine the predictors of MACE.

Results: We reviewed the data of 2772 patients (mean age=70.8±4.7 years, male sex=1726 patients [62.3%]) from which 393 patients (14.4%) developed MACE. In the multivariable regression model, female sex was a protective factor for MACE (hazard ratio [HR]=0.701; P=0.001), while presence of diabetes mellitus (HR=1.333; P=0.007), family history of coronary artery disease (CAD) (HR=1.489; P=0.003) and plain balloon angioplasty (HR=1.810; P=0.010) were independent risk factors for MACE.

Conclusion: PCI is a safe and effective method of revascularization in the elderly patients, and some clinical and procedural factors can predict MACE in this group of patients.

Keywords: Cohort study; Elderly; Major adverse cardiac events; Percutaneous coronary intervention.

MeSH terms

  • Aged
  • Angioplasty, Balloon / adverse effects*
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / mortality
  • Cause of Death
  • Female
  • Hospital Mortality
  • Humans
  • Iran / epidemiology
  • Male
  • Multivariate Analysis
  • Percutaneous Coronary Intervention / adverse effects*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome