Predictors of Long-term Major Adverse Cardiac Events Following Percutaneous Coronary Intervention in the Elderly

Background: We aimed to recognize the predictors of long-term major adverse cardiac events (MACE) in the elderly candidates for elective percutaneous coronary intervention (PCI) at our center. Methods: In this retrospective cohort study, we reviewed the data of the elderly (age ≥65 years) candidates for elective PCI who met our study criteria, at Tehran heart center between 2004 and 2013. Demographic, anthropometric, clinical, angiographic, procedural and follow-up data of the enrolled patients were retrieved from the angiography/PCI databank of our center. The study characteristics of the patients with or without MACE were compared in a univariable Cox-regression analysis. A multivariable Cox-regression model was applied using variables selected from the univariable model to determine the predictors of MACE. Results: We reviewed the data of 2772 patients (mean age = 70.8±4.7 years, male sex=1726 patients [62.3%]) from which 393 patients (14.4%) developed MACE. In the multivariable regression model, female sex was a protective factor for MACE (hazard ratio [HR] = 0.701; P = 0.001), while presence of diabetes mellitus (HR = 1.333; P=0.007), family history of coronary artery disease (CAD) (HR = 1.489; P = 0.003) and plain balloon angioplasty (HR = 1.810; P = 0.010) were independent risk factors for MACE. Conclusion: PCI is a safe and effective method of revascularization in the elderly patients, and some clinical and procedural factors can predict MACE in this group of patients.