Is 90 the New 80? Temporal Trends in Nonagenarians Undergoing Percutaneous Coronary Interventions.

Nonagenarians Octogenarians Trends

Journal

The American journal of the medical sciences
ISSN: 1538-2990
Titre abrégé: Am J Med Sci
Pays: United States
ID NLM: 0370506

Informations de publication

Date de publication:
02 Jul 2024
Historique:
received: 15 12 2023
revised: 24 06 2024
accepted: 26 06 2024
medline: 5 7 2024
pubmed: 5 7 2024
entrez: 4 7 2024
Statut: aheadofprint

Résumé

Coronary artery disease (CAD) is a leading cause of death in the elderly population. Data regarding percutaneous coronary interventions (PCIs) in nonagenarians are scarce, and differences in long term outcomes between generations remain unclear. We aimed to study the pattern and temporal trends of nonagenarians treated with PCI. A total of 14,695 patients underwent PCI between 2009-2020. We identified 2,034 (13.8%) octogenarians (age 80-89), and 222 (1.5%) nonagenarians (age 90-99). Endpoints included mortality and major adverse cardiac events (MACE) at 1 year. The number of nonagenarians undergoing PCI has increased substantially during the study time period, from 89 patients in the earlier time period (2009-2014) to 133 patients in the later time period (2015-2020). At 1-year, nonagenarians had significantly higher rates of both death (24.3% vs. 14.9%, p<0.01), and MACE (30.6% vs. 22.0%, p<0.01), as compared to octogenarians. The cumulative survival rate was higher among octogenarians both in the early and late time period (p<0.01 and p=0.039, respectively). A significant reduction in nonagenarian MACE rates were observed during the study time period, resulting in a non-significant difference in MACE rates in the later time period between both groups. The number of nonagenarians who undergo PCI is on the rise. While their clinical outcomes are inferior as compared to younger age groups, improvement was noted in the late time period.

Sections du résumé

BACKGROUND BACKGROUND
Coronary artery disease (CAD) is a leading cause of death in the elderly population. Data regarding percutaneous coronary interventions (PCIs) in nonagenarians are scarce, and differences in long term outcomes between generations remain unclear. We aimed to study the pattern and temporal trends of nonagenarians treated with PCI.
MATERIALS AND METHODS METHODS
A total of 14,695 patients underwent PCI between 2009-2020. We identified 2,034 (13.8%) octogenarians (age 80-89), and 222 (1.5%) nonagenarians (age 90-99). Endpoints included mortality and major adverse cardiac events (MACE) at 1 year.
RESULTS RESULTS
The number of nonagenarians undergoing PCI has increased substantially during the study time period, from 89 patients in the earlier time period (2009-2014) to 133 patients in the later time period (2015-2020). At 1-year, nonagenarians had significantly higher rates of both death (24.3% vs. 14.9%, p<0.01), and MACE (30.6% vs. 22.0%, p<0.01), as compared to octogenarians. The cumulative survival rate was higher among octogenarians both in the early and late time period (p<0.01 and p=0.039, respectively). A significant reduction in nonagenarian MACE rates were observed during the study time period, resulting in a non-significant difference in MACE rates in the later time period between both groups.
CONCLUSION CONCLUSIONS
The number of nonagenarians who undergo PCI is on the rise. While their clinical outcomes are inferior as compared to younger age groups, improvement was noted in the late time period.

Identifiants

pubmed: 38964467
pii: S0002-9629(24)01330-2
doi: 10.1016/j.amjms.2024.06.029
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Auteurs

Ori Rahat (O)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ori.rahat@gmail.com.

Mark Kheifets (M)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Tamir Bental (T)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Shelly Abigail Vons (S)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ori Tishler (O)

Internal Department F, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Tsahi T Lerman (TT)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Internal Department F, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Caroline Kaufman (C)

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Leor Perl (L)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Gabriel Greenberg (G)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Pablo Codner (P)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Guy Witberg (G)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Hana Vaknin-Assa (H)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ran Kornowski (R)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Amos Levi (A)

Department of Cardiology, Rabin Medical Center, Petach Tikva; affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Classifications MeSH