Author + information
- S1936879815020932-10b6aa00c2af53f382211caa2da63821Meena R. Narayanan,
- S1936879815020932-8a0d83c4defd40a95174b9636fbf703aAnisha Rastogi,
- S1936879815020932-4d352f7b9747aad55d01862c31e8e7d1Rajan Shah,
- S1936879815020932-6f602475989092ce09105667b5679d08Leonardo Clavijo,
- S1936879815020932-d54a419011ec9134c195704db787dd08Ray Matthews,
- S1936879815020932-36dc6d39f153d8b7694abff78d43d9d2David Shavelle,
- S1936879815020932-8ae72cba076ad46bb44f6f0885c87d5cHan Tun and
- S1936879815020932-005cb43cbb95cef5e01cc57133f8078cAnil Mehra
Elderly patients are well known to have higher mortality rates associated with coronary surgical revascularization. The Society of Thoracic Surgeons (STS) score and the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II are well known risk stratification models in which age plays an incremental factor. In the present study, we report our experience of surgically rejected octogenarians with unprotected left main coronary artery (ULMCA) stenosis undergoing percutaneous coronary intervention (PCI).
From April 2008 to June 2014, 71 patients with ULMCA stenosis were considered high risk for surgical revascularization and underwent PCI. Patients were divided based upon age less than 80 years (n=53) and greater than 80 years (n=18). STS, EuroSCORE II, Syntax score, use of device support and 30 day and 1 year mortality were assessed.
Baseline characteristics were similar, except octogenarians had lower rates of diabetes (22% vs. 55%) and higher rates of advanced chronic kidney disease (61% vs 30%). Compared to younger patients, octogenarians had a significantly higher STS Score (14.1 ± 3.0 vs 6.5 ±9.3, p=0.009) and EuroSCORE II (17.0 ± 18.7 vs 8.2 ± 9.2, p=0.01). There was no difference in Syntax score between the 2 groups, 24.6 ± 12.1 vs 24.1 ± 12.1, p=NS. The type of device support (Intra Aortic Balloon Pump, Impella or Tandem Heart) did not differ between the groups. Need for temporary dialysis during hospitalizations did not differ (20% vs 20%, p=NS). Average length of stay was comparable (8.4 ± 8.6 vs 12.0 ±10.7, p=NS). 30 day mortality (17% vs 4%, p=NS) and 1 year mortality (28% vs 21%, p=NS) were similar between the groups.
When compared to younger patients, octogenarians with ULMCA stenosis undergoing PCI have similar short and long-term outcomes despite having a higher baseline STS Score and EuroSCORE II.