Impact of age on outcomes of percutaneous coronary intervention in acute coronary syndromes patients

Percutaneous coronary intervention (PCI) is a safe and effective procedure to reconstitute myocardial perfusion and has been demonstrated to improve prognosis in patients with acute coronary syndrome. With advancing age, PCI carries a higher risk for acute coronary and other vascular complications. Periprocedural mortality risk after PCI demonstrates a curvilinear relationship with age, with the highest mortality rates in the elderly. However, the magnitude of risk depends strongly on the presence and severity of additional clinical, angiographic and procedural factors. Among patients with acute coronary syndrome, the most meaningful mortality predictors are hemodynamic instability and acute ST elevation myocardial infarction. In addition, comorbidities such as renal insufficiency, diffuse and calcified coronary pathology and procedural complications increase the risk for death. Therefore, decision-making in interventional procedures is not solely dependent on the numerical age but mainly on additional factors. However, despite a higher rate of complications, PCI has been shown to improve clinical outcomes in the elderly with acute coronary syndrome.