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Percutaneous coronary intervention for unprotected left main distal bifurcation lesions in elderly people.
Watanabe, Yusuke; Naganuma, Toru; Chieffo, Alaide; Montorfano, Matteo; Colombo, Antonio.
Afiliación
  • Watanabe Y; San Raffaele Scientific Institute, Milan, Italy.
  • Naganuma T; Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan.
  • Chieffo A; Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan.
  • Montorfano M; San Raffaele Scientific Institute, Milan, Italy.
  • Colombo A; San Raffaele Scientific Institute, Milan, Italy.
Catheter Cardiovasc Interv ; 104(2): 181-190, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38988147
ABSTRACT

BACKGROUND:

In the elderly people with unprotected left main distal bifurcation lesions (ULMD), percutaneous coronary intervention (PCI) is often selected as first choice treatment strategy because of perioperative high risk of coronary artery bypass graft surgery due to their large number of comorbidities. Also, some recent papers reported that geriatric nutritional risk index (GNRI) is also strongly associated with clinical outcomes after interventional procedures in elderly patients.

OBJECTIVES:

We assessed clinical outcomes after PCI for ULMD and the impact of GNRI in elderly patients.

METHODS:

We identified 669 non dialysis patients treated with current generation drug-eluting stent for ULMD from MITO registry. We divided the patients to the following 2 groups; elderly group (n = 240, age ≥75) and young group (n = 429, age <75). Additionally, we could calculate GNRI and divided elderly group into 2 group based on the median value of the GNRI. The primary endpoint was all-cause mortality.

RESULTS:

All-cause mortality was significantly higher in elderly group [adjusted hazard ratio (HR) 2.37; 95% confidence interval (CI), 1.40-4.02; p = 0.001]. All-cause mortality was significantly higher in low GNRI elderly group compared to other 2 groups (Adjusted HR of elderly with low GNRI 3.56, 95%CI (1.77-7.14), p < 0.001). Cardiovascular mortality was comparable between two groups. TLR rate was significantly lower in elderly group (adjusted HR 0.57; 95% CI, 0.34-0.97; p = 0.035).

CONCLUSIONS:

The elderly had higher all-cause mortality after PCI for ULMD compared to young people. Especially, the elderly with low GNRI were extremely associated with poorer outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Evaluación Geriátrica / Sistema de Registros / Stents Liberadores de Fármacos / Intervención Coronaria Percutánea Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Evaluación Geriátrica / Sistema de Registros / Stents Liberadores de Fármacos / Intervención Coronaria Percutánea Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Catheter Cardiovasc Interv Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos