Association of age with adverse events following coronary atherectomy during percutaneous coronary intervention.
10.26599/1671-5411.2025.05.007
- Author:
Dae Yong PARK
1
;
Jiun-Ruey HU
2
;
Sean DEANGELO
3
;
Aviral VIJ
4
;
Yasser JAMIL
5
;
Golsa BABAPOUR
1
;
Zafer AKMAN
6
;
Parsa PAZOOKI
7
;
Abdulla A DAMLUJI
8
;
Jennifer Frampton DO
1
;
Darrick K LI
9
;
Michael G NANNA
1
Author Information
1. Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA.
2. Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
3. Department of Medicine, Cook County Health, Chicago, IL, USA.
4. Division of Cardiology, Cook County Health, Chicago, IL, USA.
5. Department of Cardiology, Inova Heart and Vascular Institute, Falls Church, VA, USA.
6. Department of Medicine, Yale School of Medicine, New Haven, CT, USA.
7. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
8. Cardiovascular Center on Aging, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
9. Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, USA.
- Publication Type:Journal Article
- From:
Journal of Geriatric Cardiology
2025;22(5):497-505
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Coronary atherectomy is used to treat severely calcified coronary artery lesions which are more frequent with increasing age, but its impact in older adults has not been sufficiently examined.
METHODS:We compared adults ≥ 18 years old who underwent coronary atherectomy during inpatient PCI in 2016-2023 from the Vizient Clinical Data Base and compared outcomes in younger (< 65 years), youngest-old (65-74 years), middle-old (75-84 years), and oldest-old (≥ 85 years) adults. Primary outcome was in-hospital mortality, and secondary outcomes included postprocedural complications.
RESULTS:Among 47,337 patients who underwent coronary atherectomy, 19,862 (42.0%) were younger adults and 27,475 (58.0%) were older adults, including 13,583 youngest-old, 10,206 middle-old, and 3,686 oldest-old adults. Compared with younger adults, youngest-old adults had higher mortality (adjusted odds ratio [aOR] = 1.37, P < 0.001), ischemic stroke (aOR = 1.35, P = 0.005), gastrointestinal hemorrhage (GIH) (aOR = 1.44, P < 0.001), acute kidney injury (AKI) (aOR = 1.43, P < 0.001), tamponade (aOR = 1.86, P < 0.001), and pericardiocentesis (aOR = 2.32, P < 0.001). Middle-old adults had higher mortality (aOR = 1.80, P < 0.001), GIH (aOR = 1.42, P = 0.002), AKI (aOR = 1.63, P < 0.001), tamponade (aOR = 2.52, P < 0.001), and pericardiocentesis (aOR = 3.13, P < 0.001). Oldest-old adults had the highest odds for mortality (aOR = 2.03, P < 0.001), GIH (aOR = 1.48, P = 0.016), AKI (aOR = 2.26, P < 0.001), tamponade (aOR = 3.86, P < 0.001), and pericardiocentesis (aOR = 4.21, P < 0.001). There was a significant interaction (P-interaction=0.035) between atherectomy and age groups with regard to the odds of in-hospital mortality.
CONCLUSIONS:In this large claims-based study, in-hospital mortality, GIH, AKI, tamponade, and pericardiocentesis were higher in older adults compared with younger adults, in a stepwise manner by age group.
