Clinical characteristics and prognosis of very elderly patients with coronary artery disease

Background: Elderly patients with coronary heart disease (CHD), especially the super-elderly, have been significantly increasing in number and are being referred for percutaneous coronary intervention. Methods: The present study is a retrospective analysis conducted in Anzhen Hospital from January 2007 to December 2015. The very elderly group, composed of 443 CHD patients aged >= 80 years, were compared with a control group consisting of 400 matching patients aged <= 65 years. Comparisons conducted between the 2 groups included the medical history, clinical characteristics, features of coronary artery lesions, and clinical events. Results: There were higher rates of old myocardial infarction, revascularization, and most complications (both cardiogenic and non-cardiogenic) in the elderly group than in the control group. Meanwhile, the levels of low-density lipoprotein-cholesterol and hemoglobin, and the left ventricular ejection fraction in the elderly group were lower than that in the control group (all P<0.05). Furthermore, fasting glucose and serum creatinine in the elderly group were higher than those in the control group (P<0.05). The very elderly patients had more multivessel lesions, left main involvement, and chronic total occlusions than the control group (all P<0.05). The rates of in-hospital bleeding and death were not different between the 2 groups, but at 1 year, the rates of cardiovascular re-hospitalization, all-cause mortality, and cardiovascular mortality in the very elderly group were higher than that in the control group (all P<0.05). Conclusion: Very elderly CHD patients had more risk factors, more complex coronary artery lesions, worse prognosis, and more complications than younger patients.