Bifurcation Percutaneous Coronary Intervention in Patients Aged ≥80 Years: Insights from the Prospective Global Registry for the Study of Bifurcation Lesion Interventions Registry

Abstract

The outcomes of bifurcation percutaneous coronary intervention (PCI) in patients aged ≥80 and ≥90 years have received limited study. We compared the procedural characteristics and outcomes of bifurcation PCIs in patients aged ≥80 years and those aged <80 years in a multicenter registry. Of 1,253 patients who underwent 1,262 bifurcation PCIs between 2014 and 2024 at 6 centers, 194 (15%) were aged ≥80 and ≥90 years. These patients were more likely to have atrial fibrillation (30 vs 12%, p <0.001) and heart failure (39 vs 19%, p <0.001) than were younger patients. They were more likely to have bifurcation lesions with greater angiographic complexity, including severe calcification (38% vs 14%, p <0.001) and left main coronary artery (30% vs 0%, p <0.001) and left anterior descending artery (80% vs 70%, p <0.001) stenoses. Patients aged ≥80 years had lower procedural success (87% vs 92%, p = 0.026) and greater incidence of in-hospital major adverse cardiovascular events (MACE, 8.3% vs 3.4%, p = 0.002) and death (3.1% vs 1%, p = 0.035). During a median follow-up of 903 days, patients aged ≥80 years had greater follow-up MACE (47.3% vs 28.1%, p <0.001), mortality (38.4% vs 10.9%, p <0.001), and stroke (6.8% vs 2.9%, p = 0.018) than did younger patients. In multivariable analysis, follow-up MACE was independently associated with age ≥80 years (hazard ratio 1.46, 95% confidence intervals 1.05 to 2.04, p = 0.026). In conclusion, success rates were lower than those in younger patients and the risk of complications greater in patients aged ≥80 years who underwent bifurcation PCI.