[Complications of coronary invasive procedures in nonagenarians: A case-control study].

Autor: Raoul F; Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: florian.raoul@ch-troyes.fr., Sanchez S; Pôle territorial santé publique et performance, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: stephane.sanchez@ch-troyes.fr., Dacunka M; Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: marianne.dacunka@ch-troyes.fr., Nazeyrollas P; Pôle vasculaire, service de cardiologie, centre hospitalo-universitaire de Reims, 52, avenue Cognacq-Jay, 51100 Reims, France. Electronic address: pnazeyrollas@chu-reims.fr., Al Amoura A; Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: alaa.alamoura@ch-troyes.fr., Girodet B; Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: bertrand.girodet@ch-troyes.fr., Mailler B; Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: bruno.maillier@ch-troyes.fr., Chapoutot L; Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: laurent.chapoutot@ch-troyes.fr., Marchais A; Pôle vasculaire, service de cardiologie, centre hospitalier de Troyes, 101, avenue Anatole-France, 10000 Troyes, France. Electronic address: aurelie.marchais@ch-troyes.fr.
Jazyk: francouzština
Zdroj: Annales de cardiologie et d'angeiologie [Ann Cardiol Angeiol (Paris)] 2020 Nov; Vol. 69 (5), pp. 219-226. Date of Electronic Publication: 2020 Aug 13.
DOI: 10.1016/j.ancard.2020.07.008
Abstrakt: Introduction: Coronary heart disease is the leading cause of morbidity and mortality in nonagenarians, whose numbers have doubled in twenty years. In the absence of recommendations, the place of coronary invasive strategy in this population remains a therapeutic challenge and its interest as well as its risks are poorly established. The aim of our study was to evaluate the safety of coronary invasive practice in the nonagenarian population for all indications.
Population and Methods: This was a monocentric case-control study conducted from January 1, 2010 to May 30, 2019. The patients included were all nonagenarians who had undergone coronary angiography at the centre hospitalier de Troyes during this period. For each patient included, two controls matched on sex, date of procedure and procedure were drawn at random. The main judgment criterion was the occurrence of immediate per- or post-procedure complications during the stay in which the procedure was performed. The main secondary outcome measures were average length of stay, occurrence of intercurrent events during the stay (nosocomial infections, confusional syndrome), and loss of autonomy.
Results: In all, 59 nonagenarians and 118 controls were included in our study. We identified 30.5% major complications in the nonagenarians versus 10.2% in the controls (P=0.001; OR=0.26 [0.1-0.6]), with a significant difference in the occurrence of cardiogenic shock (P=0.04), heart failure (P=0.02) and ventricular rhythm disorders (P=0.04). Post-procedure acute renal failure was greater in the nonagenarians (P=0.02; OR=0.20 [0.05-1.57]). The mean length of stay was on average twice as long in the nonagenarians.
Conclusion: Nonagenarian patients are subject to more complications when undergoing coronary invasive procedures compared to patients under 75.
(Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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