COMPARISON OF SHORT-TERM OUTCOMES OF STAGED VERSUS ONE-TIME MULTIVESSEL PCI IN ELDERLY

Abstract

Objective: To compare the short-term clinical outcomes of staged versus one-time multivessel percutaneous coronary intervention (PCI) in elderly patients.

Study Design: Cross-sectional study.

Place and Duration of Study: Three months study at Post Cath wards of Armed Forces Institute of Cardiology.

Material and Methods: We analysed the data of patients with multivessel percutaneous coronary intervention (PCI) who were enrolled in AFIC/NIHD. A total of286 eligible patients aged ≥ 60 were further categorized into “one-time” group (n=119) and staged PCI group (n= 48) according to intervention strategy. The primary endpoint was composite outcome of survival (discharged) or contrast induced nephropathy or stent thrombosis acute or subacute or cardiac death during 48to 72 hours follow-up.

Results: The estimated 48 to 72 hours composite rate of cardiac death was 1.9% in the staged PCI group and 2.2% in the “one-time” group. Multivariate analysis confirmed the benefit of staged PCI on the primary events in the elderly (co-morbids p= 0.007). Staged PCI was associated with more stable patients and the discharged rate was higher i.e., 39.9% than one-time PCI (33.6%). There was no difference in target vessel revascularization (1.1% vs. 1.1%).

Conclusion: In elderly patients with MVD, staged PCI might be an optimal strategy associated with reduced short-term cardiac death or major cardiovascular events compared with “one-time” PCI strategy, which needs further confirmation.