Abstract
BACKGROUND: The data on long-term outcomes for elderly patients with coronary artery disease who undergo invasive treatment is limited. This study aimed to assess long-term outcomes and risk factors for patients over 80 years of age who underwent revascularisation. METHODS: This single-centre retrospective study included ≥80-year-old patients who underwent coronary angiography between 2012 and 2014. Among 590 study patients, 411 patients had significant angiographic changes and had either a percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) performed. Baseline patient characteristics, including demographics, comorbidities, survival to hospital discharge, and long term mortality were analysed. Three-year mortality was assessed. RESULTS: Three hundred sixty-nine (89.8%) patients underwent PCI and in 42 (10.2%) CABG was performed. Significant differences between groups were detected in heart failure (PCI - 51.2% vs. CABG - 78.6%; p = 0.001), previous CABG (11.4% vs. 0%; p = 0.014), cardiogenic shock (12.2% vs. 0%; p = 0.008). Hospital mortality rate in the PCI group - 10.6%, CABG - 7.1%; p = 0.787. A median 3-year survival rate in the PCI group - 66.1%, CABG - 66.7%; p = 1.000. Chronic heart failure (OR 2.442; 95% CI: 1.530-3.898, p < 0.001), atrial fibrillation (OR 0.425; 95% CI: 0.261-0.692, p < 0.001), cardiogenic shock (OR 0.120; 95% CI: 0.054-0.270, p = 0.001), and LMCA stenosis (OR 2.104; 95% CI: 1.281-3.456, p = 0.003) were identified as independent 3-year all-cause mortality predictors in multivariate regression analysis. CONCLUSIONS: There was no significant difference in hospital mortality and survival rates between elderly patients who underwent PCI or CAGB. The majority of elderly patients underwent a PCI and these patients appeared to experience cardiogenic shock more frequently.