Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction)

Lisbeth Antonsen, Lisette Okkels Jensen, Per Thayssen, Evald Høj Christiansen, Anders Junker, Hans-Henrik Tilsted Hansen, Christian Juhl Terkelsen, Anne Kaltoft, Michael Maeng, Knud Noerregaard Hansen, Jan Ravkilde, Jens Flensted Lassen, Morten Madsen, Henrik Toft Sørensen, Leif Thuesen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.
OriginalsprogEngelsk
TidsskriftAmerican Journal of Cardiology
Vol/bind108
Udgave nummer10
Sider (fra-til)1395-400
Antal sider6
ISSN0002-9149
DOI
StatusUdgivet - 2011

Fingeraftryk

Stable Angina
Confidence Intervals
Denmark
Non-ST Elevated Myocardial Infarction
ST Elevation Myocardial Infarction
Registries
Coronary Artery Disease
Regression Analysis
Population

Citer dette

Antonsen, Lisbeth ; Jensen, Lisette Okkels ; Thayssen, Per ; Christiansen, Evald Høj ; Junker, Anders ; Hansen, Hans-Henrik Tilsted ; Terkelsen, Christian Juhl ; Kaltoft, Anne ; Maeng, Michael ; Hansen, Knud Noerregaard ; Ravkilde, Jan ; Lassen, Jens Flensted ; Madsen, Morten ; Sørensen, Henrik Toft ; Thuesen, Leif. / Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction). I: American Journal of Cardiology. 2011 ; Bind 108, Nr. 10. s. 1395-400.
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title = "Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction)",
abstract = "Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4{\%}) in 2002 to 588 (10.2{\%}) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2{\%}, ST-segment elevation myocardial infarction (STEMI) in 35.0{\%}, UAP/non-STEMI in 29.7{\%}, and {"}ventricular arrhythmia or congestive heart failure{"} in 5.1{\%}. Overall 30-day and 1-year mortality rates were 9.2{\%} and 18.1{\%}, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95{\%} confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95{\%} confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95{\%} confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1{\%} in 2002 to 2.5{\%} in 2008. In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.",
keywords = "Aged, 80 and over, Angina, Stable, Angina, Unstable, Angioplasty, Balloon, Coronary, Arrhythmias, Cardiac, Cohort Studies, Comorbidity, Coronary Artery Disease, Denmark, Female, Follow-Up Studies, Heart Failure, Humans, Male, Myocardial Infarction, Registries, Regression Analysis",
author = "Lisbeth Antonsen and Jensen, {Lisette Okkels} and Per Thayssen and Christiansen, {Evald H{\o}j} and Anders Junker and Hansen, {Hans-Henrik Tilsted} and Terkelsen, {Christian Juhl} and Anne Kaltoft and Michael Maeng and Hansen, {Knud Noerregaard} and Jan Ravkilde and Lassen, {Jens Flensted} and Morten Madsen and S{\o}rensen, {Henrik Toft} and Leif Thuesen",
note = "Copyright {\circledC} 2011 Elsevier Inc. All rights reserved.",
year = "2011",
doi = "10.1016/j.amjcard.2011.06.062",
language = "English",
volume = "108",
pages = "1395--400",
journal = "The American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier",
number = "10",

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Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction). / Antonsen, Lisbeth; Jensen, Lisette Okkels; Thayssen, Per; Christiansen, Evald Høj; Junker, Anders; Hansen, Hans-Henrik Tilsted; Terkelsen, Christian Juhl; Kaltoft, Anne; Maeng, Michael; Hansen, Knud Noerregaard; Ravkilde, Jan; Lassen, Jens Flensted; Madsen, Morten; Sørensen, Henrik Toft; Thuesen, Leif.

I: American Journal of Cardiology, Bind 108, Nr. 10, 2011, s. 1395-400.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction)

AU - Antonsen, Lisbeth

AU - Jensen, Lisette Okkels

AU - Thayssen, Per

AU - Christiansen, Evald Høj

AU - Junker, Anders

AU - Hansen, Hans-Henrik Tilsted

AU - Terkelsen, Christian Juhl

AU - Kaltoft, Anne

AU - Maeng, Michael

AU - Hansen, Knud Noerregaard

AU - Ravkilde, Jan

AU - Lassen, Jens Flensted

AU - Madsen, Morten

AU - Sørensen, Henrik Toft

AU - Thuesen, Leif

N1 - Copyright © 2011 Elsevier Inc. All rights reserved.

PY - 2011

Y1 - 2011

N2 - Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.

AB - Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time.

KW - Aged, 80 and over

KW - Angina, Stable

KW - Angina, Unstable

KW - Angioplasty, Balloon, Coronary

KW - Arrhythmias, Cardiac

KW - Cohort Studies

KW - Comorbidity

KW - Coronary Artery Disease

KW - Denmark

KW - Female

KW - Follow-Up Studies

KW - Heart Failure

KW - Humans

KW - Male

KW - Myocardial Infarction

KW - Registries

KW - Regression Analysis

U2 - 10.1016/j.amjcard.2011.06.062

DO - 10.1016/j.amjcard.2011.06.062

M3 - Journal article

C2 - 21890087

VL - 108

SP - 1395

EP - 1400

JO - The American Journal of Cardiology

JF - The American Journal of Cardiology

SN - 0002-9149

IS - 10

ER -