J Clin Outcomes Manage
Safety and efficacy of cardiac catheterization in nonagenarians
Kanwar M, Aleksonis D, Kolluru A, Awasthi A, Rosman HS
Abstract Objective: The elderly comprise the fastest growing segment of the U.S. population, but data on cardiac catheterization in this age-group are scarce. We present a series of 191 nonagenarians who underwent cardiac catheterization at our institution. Methods: Retrospective data were collected for 191 nonagenarians who underwent cardiac catheterizations from 1994 to 2006. Variables were defined per the National Cardiovascular Network (NCN) data registry recommendations. Results: The mean age of the study group was 91.4 ± 1 years, and 65% of the patients were women. Diabetes, hypertension, peripheral vascular disease, and smoking were present in 18%, 87%, 35%, and 27% of patients, respectively. At presentation, 79% had acute coronary syndrome (56% with unstable angina and 23% with acute myocardial infarction) and 48% had multivessel disease. Percutaneous coronary intervention (PCI) was performed in 122 patients (135 vessels) with coronary stents used in 74%. Angiographic success was achieved in 90.6% of cases. There were 45 documented in-hospital complications (4 deaths, 2 Q wave myocardial infarctions, 3 strokes, 9 cases of renal failure, and 27 vascular complications) and 29 deaths at 1-year follow-up. Conclusion: Most nonagenarians have a high-risk profile, but cardiac catheterization and PCI can be an acceptable option in selected patients.
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