Objectives: The aim of this study was to determine temporal trends, in-laboratory complications, mortality, and predictors of mortality among nonagenarians undergoing percutaneous coronary intervention (PCI).
Background: Nonagenarians (patients 90 years of age or older) undergoing PCI are often underrepresented in clinical trials, and their management remains challenging and controversial.
Methods: All veterans undergoing PCI with data recorded in the Veterans Affairs Clinical Assessment, Reporting, and Tracking program from 2005 to 2014 were evaluated. Temporal trends in the use of PCI, occurrence of in-laboratory complications, and 30-day and 1-year mortality were assessed. Using a frailty model, predictors of 30-day and 1-year mortality in nonagenarians were evaluated.
Results: Among all veterans undergoing PCI (n = 67,148) between 2005 and 2014, 274 (0.4%) were nonagenarians. The proportion of nonagenarians increased from 0.25% in 2008 to 0.58% in 2014. Compared with younger patients, nonagenarians had a greater risk for acute cardiogenic shock post-procedure (0.73% vs. 0.12%; p = 0.04) and no reflow (2.9% vs. 1.0%; p = 0.02). Unadjusted (10.6% vs. 1.4%; p < 0.0001) and adjusted 30-day mortality (odds ratio: 2.14; 95% confidence interval [CI]: 1.42 to 3.22) and unadjusted (16.3% vs. 4.2%; p < 0.0001) and adjusted 1-year mortality (odds ratio: 1.82; 95% CI: 1.27 to 2.62) were higher among PCI patients who were nonagenarians. The National Cardiovascular Data Registry risk score was highly predictive of both 30-day (hazard ratio: 2.29; 95% CI: 1.86 to 2.82) and 1-year (hazard ratio: 1.43; 95% CI: 1.07 to 1.90) mortality among nonagenarians.
Conclusions: Nonagenarians were a small but growing population with worse 30-day and 1-year mortality. The National Cardiovascular Data Registry risk score was a strong predictor of mortality in these patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcin.2017.03.051 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intubation Practices in Community Emergency Departments.
Ann Emerg Med
January 2025
Department of Emergency Medicine, Kaiser Permanente San Diego Medical Center, San Diego, CA.
Study Objective: This study analyzes emergency medicine airway management trends and outcomes among community emergency departments.
Methods: A multicenter, retrospective chart review was conducted on 11,475 intubations from 15 different community emergency departments between January 1, 2015, and December 31, 2022. Data collected included patient's age, sex, rapid sequence intubation medications, use of cricoid pressure, method of intubation, number of attempts, admission diagnosis, and all-cause mortality rates.
Transcatheter Left Ventricular Reconstruction in Heart Failure Patients With Prior Anterior Myocardial Infarction: The Prospective ALIVE Trial.
JACC Heart Fail
January 2025
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Background: Left ventricular (LV) dilatation and extensive scar portend a poor prognosis in heart failure (HF). The Revivent TC system (BioVentrix Inc) is used either during a hybrid transcatheter-surgical or a surgical-only procedure to exclude transmural scar and reduce LV dimensions.
Objectives: The purpose of this study was to examine the safety and efficacy of the Revivent TC® anchor system in patients with HF.
Associations Between Peak Expiratory Flow and Community Mobility Loss Among Older Adults in the United States.
J Am Geriatr Soc
January 2025
Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Background: Community mobility is a vital patient-centered outcome for older adults living in the community. These deficits in mobility are linked to social isolation, increased hospitalizations, and higher mortality rates. Impaired pulmonary function may be a modifiable risk factor for mobility decline, with existing inequities in lung health potentially contributing disproportionately to mobility loss among Black older adults.
View Article and Find Full Text PDFReal-world analysis of acamprosate use in patients with cirrhosis and alcohol-associated hepatitis.
BMJ Open Gastroenterol
December 2024
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Objective: Preventing return to alcohol is of critical importance for patients with alcohol-related cirrhosis and/or alcohol-associated hepatitis. Acamprosate is a widely used treatment for alcohol use disorder (AUD). We assessed the impact of acamprosate prescription in patients with advanced liver disease on abstinence rates and clinical outcomes.
View Article and Find Full Text PDFResistance reduction and cross-resistance of spinosad-resistant Rhyzopertha dominica (Coleoptera: Bostrichidae) and the association between spinosad resistance and maltase activity.
Pest Manag Sci
January 2025
Department of Entomology, National Chung Hsing University, Taichung City, Taiwan.
Background: The lesser grain borer, Rhyzopertha dominica, is a serious stored-products pest mainly controlled by insecticides. Spinosad, an environmentally friendly biological insecticide with low mammalian toxicity, is considered a suitable candidate for R. dominica management.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!