Percutaneous coronary interventions in very elderly patients referred for symptomatic coronary disease

The elderly population is increasing and has a high cardiovascular risk. This population has been systematically excluded from clinical trials. So much so, the evidence about the best treatment to offer them is unknown. Methods: We analyzed data from 63 consecutive patients> 85 years who underwent percutaneous coronary intervention in order to obtain the results for those patients who were offered percutaneous treatment for their symptomatic coronary disease. They were divided into 3 clinical groups (unstable angina, NSTEMI or STEMI) and for monitoring into 2 groups (hospitalization until the first month and up to 1 year). Results: The average age of patients was 87.5 (SD 3), 66.7% men and 33.3% women. 33.3% presented with STEMI, 38% with NSTEMI and 28.7% with unstable angina. There were 1.3 (SD 1) PCI performed on average. Radial access was 36%. Complications related to the procedure were 24% acute renal failure or preexisting failure worsening, and 2% required dialysis. 12% of major bleeding, 5% periprocedural MI. There were no strokes. The overall cardiovascular mortality was 17% during hospitalization in up to one month (with 5%, 13% and 33% respectively for unstable angina, NSTEMI or STEMI) and 20% at one year. The average hospital stay was 5.44 days (SD 6). Conclusion: Acute coronary syndrome in the elderly can be treated invasively with acceptable risks. The chronological age should not be the main determining factor in the decision of invasive treatment.