Does Age of patient at influence Outcomes of PCI for Acute Coronary Syndrome? – Single-center Comparative Prospective Longitudinal Study

International Journal of Medical Science

© 2021 by SSRG - IJMS Journal

Volume 8 Issue 4

Year of Publication : 2021

Authors : Jacob Joseph, Indani Ashish, Bhutada Poonam, Singh Vikrant

10.14445/23939117/IJMS-V8I4P102

How to Cite?

Jacob Joseph, Indani Ashish, Bhutada Poonam, Singh Vikrant, "Does Age of patient at influence Outcomes of PCI for Acute Coronary Syndrome? – Single-center Comparative Prospective Longitudinal Study," SSRG International Journal of Medical Science, vol. 8,  no. 4, pp. 5-11, 2021. Crossref, https://doi.org/10.14445/23939117/IJMS-V8I4P102

Abstract:

Objective:
The purpose of the study was to compare the presentation, intervention, and outcomes of ACS between the young and elderly population of India.
Method:
A hospital-based prospective longitudinal interventional case-control study was performed. The follow-ups of the patients were taken over six months (June 2018 to January 2019). The study involved the comparison of Risk factors, presentation, and outcomes at one month and six months was made between young (<65 years, n=140) and elderly patients (>65 years, n=140).
Results:
The demographics of both groups were comparable. Some major risk factors Demonstrated some disparity. Major risk factors which has higher incidence in elderly patients group included Unstable Angina (99.28% vs 87.85%), STEMI (65.71% vs 45%), Breathlessness (33.57% vs 9.28%) and heart failure (22.14% vs 10.71%), history of revascularization (11.42% vs 3.57%), hypertension(56.42% vs 43.57%), cerebral vascular accident(10% vs 2.85%), and anemia (40.71% vs 18.57%). The incidence of smoking history was significantly less in elderly patients vs. younger(36.42% vs. 22.14%). Most patients [186 (66.43%) total; (75.71% vs. 57.14%)] received were treated with coronary Angioplasty over medical therapy. However, more younger patients underwent angioplasty (75.71%) when compared to elderly patients (57.14%). At discharge, the incidence of MACE and other complications, viz. heart failure, bleeding, and renal dysfunction was higher in elderly vs. young patients. At six months, the incidence of heart failure was significantly higher in the elderly. After six months, the outcomes were similar. On stratified and ratio-balanced analysis, the outcome indicated that age is a stand-alone risk factor to affect the outcomes of angioplasty adversely.
Conclusion:
This study's outcomes indicated several limitations in performing angioplasty in the elderly population when compared with the younger population. The outcome of angioplasty, despite the selection of patients, is significantly worse in the elderly population.

Keywords:

Acute Coronary Syndrome, PCI in the elderly population, PCI, Percutaneous coronary intervention, STEMI, NSTEMI, Angioplasty, Coronary Stent, PAMI

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