Archivos de cardiología de México
versão impressa ISSN 1405-9940
MIRANDA MALPICA, Emma et al. Predictors of mortality and adverse outcome in elderly high-risk patients undergoing percutaneous coronary intervention. Arch. Cardiol. Méx. [online]. 2007, vol.77, n.3, pp. 194-199. ISSN 1405-9940.
Objectives: We sought to identify predictors of in-hospital and long-term (> 1 year) mortality and major adverse cardiac events (MACE) in elderly patients referred for percutaneous coronary intervention (PCI). Methods: Seventy-three patients (> 80 years) were included. Clinical and interventional characteristics were collected retrospectively. Primary end points were in-hospital and long-term mortality, and a composite of non-fatal myocardial infarction, target vessel revascularization, urgent coronary artery bypass graft surgery, and death (MACE). Results: Eighty-three percent of the patients had acute coronary syndromes, 43% three-vessel disease, and 42% heart failure. In-hospital mortality and MACE were 16.4% and 19%, respectively. Long-term mortality and MACE were 11.3% and 16.4%, respectively. Univariate characteristics associated with in-hospital mortality and MACE were: Killip Class III-IV, heart failure, cardiogenic shock, TIMI 0-2 flow prior and after intervention, diabetes mellitus, contrast nephropathy, and presence of A-V block or atrial fibrillation (AF). Long term predictors for mortality were the presence of heart failure, cardiogenic shock, diabetes mellitus, TIMI flow 0-2 before and after intervention, and A-V block or AF. Conclusion: The identification of the factors previously mentioned may help to predict complications in elderly patients.
Palavras-chave : Percutaneous coronary intervention; Elderly; Mortality.