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Original Articles

Trends in the Association Between Age and In-Hospital Mortality After Percutaneous Coronary Intervention

National Cardiovascular Data Registry Experience

Mandeep Singh, MD, MPH; Eric D. Peterson, MD, MPH; Matthew T. Roe, MD, MHS; Fang-Shu Ou, MS; John A. Spertus, MD, MPH; John S. Rumsfeld, MD; H. Vernon Anderson, MD; Lloyd W. Klein, MD; Kalon K.L. Ho, MD, MSc and David R. Holmes, MD

From the Division of Cardiovascular Diseases (M.S., D.R.H), Mayo Clinic, Rochester, Minn; Duke Clinical Research Institute (M.T.R., F.-S.O., E.D.P.), Durham, NC; Mid America Heart Institute/UMKC (J.A.S.), Kansas City, Mo; Denver VA Medical Center (J.S.R.), Denver, Colo; University of Texas Health Science Center (H.V.A), Houston, Tex; Rush University Medical Center (L.W.K.), Chicago, Ill; and Beth Israel Deaconess Medical Center (K.K.L.H.), Boston, Mass.

Correspondence to Mandeep Singh, MD, MPH, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail singh.mandeep{at}mayo.edu

Received October 7, 2008; accepted November 24, 2008.

Background— Temporal trends and contemporary data characterizing the impact of patient age on in-hospital outcomes of percutaneous coronary interventions are lacking. We sought to determine the importance of age by assessing the in-hospital mortality of stratified age groups in the National Cardiovascular Data Registry.

Methods and Results— In-hospital mortality after percutaneous coronary intervention on 1 410 069 patients was age stratified into 4 groups—group 1 (age <40, n=25 679), group 2 (40 to 59, n=496 204), group 3 (60 to 79, n=732 574), and group 4 (80, n=155 612)—admitted from January 1, 2001, to December 31, 2006. Overall in-hospital mortality was 1.22%; in-hospital mortality was 0.60%, 0.59%, 1.26%, and 3.16% in groups 1 to 4, respectively, P<0.0001. Overall temporal improvement per calendar year in the adjusted in-hospital mortality after percutaneous coronary intervention was noted in most groups; however, this finding was significant only in the 2 older age groups, group 3 (odds ratio, 0.94; 95% CI, 0.92 to 0.96) and group 4 (odds ratio, 0.95; 95% CI, 0.92 to 0.97). The absolute mortality reduction was greatest in the most elderly group, those over the age of 80 years.

Conclusions— In-hospital mortality after percutaneous coronary intervention has fallen for all age groups over the past 6 years. However, the largest absolute reduction was seen among patients 80 years of age or older.

Key Words: age • percutaneous coronary interventions • mortality • temporal trends

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CLINICAL PERSPECTIVE

Guest Editor for this article was Antonio Colombo, MD.

Related Article

Trends in the Association Between Age and In-Hospital Mortality After Percutaneous Coronary Intervention: National Cardiovascular Data Registry Experience

Mandeep Singh, Eric D. Peterson, Matthew T. Roe, Fang-Shu Ou, John A. Spertus, John S. Rumsfeld, H. Vernon Anderson, Lloyd W. Klein, Kalon K.L. Ho, and David R. Holmes
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