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KMID : 0882420100790060661
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Korean Journal of Medicine
2010 Volume.79 No. 6 p.661 ~ p.672
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Clinical pattern changes in elderly patients who underwent percutaneous coronary intervention in the last ten years
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Kim Min-Suk
Jeong Myung-Ho
Hwang Seung-Hwan
Ko Jum-Suk
Lee Min-Goo
Sim Doo-Sun
Park Keun-Ho
Yoon Nam-Sik
Yoon Hyun-Ju
Kim Kye-Hoon
Hong Young-Joon
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
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Abstract
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Background/Aims : The objective of this study was to observe changes in the clinical patterns of Korean patients over 65 years of age who received percutaneous coronary intervention (PCI) in the past 10 years.
Methods: In total, 3,209 patients over 65 years of age [male:female; 1,950 (71.4±5.21 years):1,259 (72.5±5.47 years)] who underwent PCI between June 1999 and June 2009 were divided into four groups according to time period. Clinical characteristics, gender differences, coronary angiographic findings, and major adverse cardiac events (MACE) during a 1-year follow-up period were compared among the four groups.
Results: The gender ratio was male-dominant and no significant change was observed over the observed time period [male (60.8):female (39.2%)], but the age increased [1999-2001:2002-2004:2005-2007:2008-2009=71.2±5.11:71.4±5.26:71.9±5.25: 72.6±5.57 years; p=0.001]. The prevalence of hypertension increased over time (p=0.028), but smoking decreased (p=0.002). Hypertension was the major risk factor for males, whereas obesity was the major risk factor for female patients. MACE-free 1-year survival increased over the observed period (p=0.014). Males had higher survival rates than females (p=0.007). MACE developed in 105 (3.27%) patients during the 1-year follow-up period and predictive factors for the development of MACE were being female (p=0.001), old age (p=0.008), hypertension (p=0.049), diabetes mellitus (p=0.004), smoking (p=0.009), and low Thrombolysis In Myocardial Infarction (TIMI) flow (p=0.048) by a multivariate analysis.
Conclusions: The age of elderly patients undergoing PCI and the prevalence of hypertension increased, whereas smoking decreased over the last 10 years. Predictive factors for patients developing MACE during the one-year follow-up were associated with female gender, hypertension, diabetes mellitus, smoking, old age, and low TIMI flow.
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KEYWORD
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Age, Coronary disease, Coronary angioplasty, Myocardial ischemia, Risk factor
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