NEW YORK (Reuters Health) — In patients who are in their eighties, procedures such as angioplasty and stenting to unblock clogged coronary arteries — known collectively as percutaneous coronary intervention (PCI) — have an “acceptable outcome”.However, when PCI is performed as an emergency in this age group, it still carries substantial risk, New York investigators report in the American Journal of Cardiology.

At New York Presbyterian Hospital-Weill Cornell Medical Center in New York City, Dr. Dmitriy N. Feldman and colleagues used the New York State Angioplasty Registry of 2000-2001 to compare in-hospital deaths and major adverse events in three age groups: patients younger than 60 years of age, those between 60 and 80, and patients older than 80 years of age.

There were 10,964 patients undergoing emergency PCI and 71,176 patients undergoing non-emergency PCI.

For patients undergoing emergency PCI, the in-hospital mortality rates were 1.0 percent, 4.1 percent and 11.5 percent for patients in the youngest, middle and oldest age groups, respectively. Among patients undergoing non-emergency PCI, mortality rates were 0.1 percent, 0.4 percent and 1.1 percent, respectively.

“Therefore, in the very elderly patients, a thorough discussion about risks and benefits of percutaneous revascularisation is needed, particularly if emergency PCI is being considered,” Dr. Feldman commented to Reuters Health.

“Our overall mortality in the 60-80 group was 0.8 percent and in the older-than-80 group it was 2.2 percent, which is lower than previously reported in patients undergoing PCI in the late 1990s.

This suggests that PCI outcomes have improved,” he pointed out.

Feldman concluded that “elective PCI procedures in the elderly are safe and have an acceptable short-term mortality when performed at experienced institutions.”