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Type: Journal article
Title: Bleeding outcomes after non-emergency percutaneous coronary intervention in the very elderly
Author: Shanmugam, V.
Wong, D.
Rashid, H.
Cameron, J.
Malaiapan, Y.
Psaltis, P.
Citation: Journal of Geriatric Cardiology, 2017; 14(10):624-631
Publisher: Science Press
Issue Date: 2017
ISSN: 1671-5411
Statement of
Vimalraj Bogana Shanmugam, Dennis T Wong, Hashrul Rashid, James D Cameron, Yuvaraj Malaiapan, Peter J Psaltis
Abstract: Background: Octogenarians constitute an increasing proportion of patients presenting for non-emergency percutaneous coronary intervention (PCI). Methods: This study evaluated the in-hospital procedural characteristics and outcomes, including the bleeding events of 293 octogenarians presenting between January 2010 and December 2012 for non-emergency PCI to a single large volume tertiary care Australian center. Comparisons were made with 293 consecutive patients aged less than or equal to 60 years, whose lesions were matched with the octogenarians. Results: Non-ST elevation myocardial infarction was the most frequent indication for non-emergency PCI in octogenarians. Compared to the younger cohort, they had a higher prevalence of co-morbidities and more complex coronary disease, comprising more type C and calcified lesions. Peri-procedural use of low molecular weight heparin (LMWH; 1.0% vs. 5.8%; P < 0.001) and glycoprotein IIb/IIIa inhibitors (2.1% vs. 9.6%; P < 0.001) was lower, while femoral arterial access was used more commonly than in younger patients (80.9% vs. 67.6%; P < 0.001). Overall, there was a non-significant trend towards higher incidence of all bleeding events in the elderly (9.2% vs. 5.8%; P = 0.12). There was no significant difference in access site or non-access site bleeding and major or minor bleeding between the two cohorts. Sub-analysis did not reveal any significant influence on bleeding rates by the use of LMWH, glycoprotein IIb/IIIa inhibitors or femoral arterial access. In addition, there were no significant differences in the rates of in-hospital mortality, stroke or acute stent thrombosis between the two groups. Conclusions: In this single center study, we did not observe significant increases in adverse in-hospital outcomes including the incidence of bleeding in octogenarians undergoing non-emergency PCI.
Keywords: Bleeding; coronary artery disease; octogenarians; percutaneous coronary intervention
Rights: ©2017 JGC All rights reserved
RMID: 0030082553
DOI: 10.11909/j.issn.1671-5411.2017.10.005
Appears in Collections:Medicine publications

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