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5 Temporal changes in percutaneous coronary intervention in the elderly
  1. P Johnston,
  2. J Mailey,
  3. K Linden,
  4. P McKavanagh
  1. Royal Victoria Hospital, Belfast, UK

Abstract

Introduction We previously reported PCI outcomes in the elderly (age ≥80) over the 2 year period 2003–4. Since then the unit has introduced routine primary PCI and TAVI. This re-audit assessed the impact of these changes on our practice and outcomes.

Methods All elderly PCI patients in 2014 were identified using the trust PCI database and 90 day outcomes obtained from the Northern Ireland electronic care record.

Results There were 257 PCIs in 241 elderly patients; 90 day outcome data was available for 239 patients. Demographics, presentation and outcomes are compared with the previous audit (which reported in-hospital and 1 year outcomes) in this Table 1.

In 2014 15.1% of our PCIs were in elderly patients (compared with 10.4% nationally, BCIS 2013 audit figures). This represents a 6 fold increase in our elderly PCI rate (2.5% vs 15.1%) over 10 years. This has been driven by a substantial increase in AMI angioplasty in the elderly (1.8% vs 33.5% of elderly PCIs). In spite of this high risk population, in-hospital mortality remained relatively low. Mortality for ≥ 80 year old patients was 15/257 (5.8%) compared with 33/1441 (2.3%) for those <80 years. Of the 15 in-hospital deaths, 12 presented with acute MI and 3 had undergone rotablation (2 pre-TAVI and one with a NSTEMI). At 90 days mortality for ≥80 year old patients was 23/255 (9.0%); 5 of the 8 deaths following discharge were non-cardiac. At 90 days a further 5 (2.0%) patients suffered a non-fatal MI and 8 (3.1%) patients suffered a CVA.

Abstract 5 Table 1

Comparison of demographics, presentation and outcomes

Conclusion The significant increase in elderly PCI observed over this 10 year period appears to be justified by outcome measures.

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