Objectives To evaluate the effect of renal insufficiency on short and long term death and major adverse cardiac event (MACE) in octogenarian patients undergoing percutaneous coronary intervention (PCI).
Methods A total of 90 patients aged 80 years and over with coronary heart disease (CAD) undergoing stenting were enrolled in this study. The in-hospital and one year clinical follow-up outcome including all-cause mortality, MACE, stroke and other major bleeding were collected and analysed. Based on estimated glomerular filtration rate level, patients were divided into two groups: estimated glomerular filtration rate < 60 ml/min (moderate to severe renal insufficiency group; n = 28) and estimated glomerular filtration rate ≥ 60 ml/min (normal/minimal renal insufficiency group; n = 62)
Results Of the 90 patients, 88.9% were acute coronary syndrome. Patients in moderate to severe renal insufficiency group were more likely to be a current smoker or to have hypertension and a history of MI. Except three vessel lesion, type-c lesion and preoperative TIMI zero grade flow, angiographic and procedure characteristics were similar between the two groups. Despite the higher risk profile, patients who in moderate to severe renal insufficiency group had a significantly higher in-hospital MACE rate (14.3% vs 4.8%; p < 0.05). During one year follow up after successful PCI, cardiac death similar (4.0% vs 1.6%; p = 0.07) and myocardial infaction (4.0% vs 1.6%; p = 0.07) were still higher in moderate to severe renal insufficiency groupthan that in normal/minimal renal insufficiency group. However, the one year survivor rate (95.3%) was high among the whole group.
Conclusions Moderate to severe renal insufficiency is an important clinical risk factor that will affect the MACE in octogenarian patients underwent PCI and also may be associated with higher in-hospital and long term MACE rate.