The one-year clinical outcomes in 3,115 octogenarians undergoing percutaneous coronary intervention with bioresorbable polymer-coated Ultimaster sirolimus-eluting stent

The aim of this study was to investigate characteristics and clinical outcomes in octogenarians undergoing PCI in the contemporary DES era.

Methods and results: The e-Ultimaster registry is a prospective, multi-centre, international registry which enrolled 36,916 patients worldwide and used the Ultimaster stent. 34,538 (93.6%) patients reached one-year follow-up and were included in this study.

3,115 patients (9.0%) were classified as the older group >80 years. (83.4±3.0 years). Patients in the older group were more frequently female (39.9% vs. 22.4%, p<0.001), and presented more often with silent ischemia but less frequently with acute coronary syndrome (ACS) than the younger group (62.4±9.9 years) (silent ischemia: 10.5% vs. 9.3%, p=0.03; ACS: 53.1% vs. 55.2%, p=0.03). The older group had more comorbidities and more complex lesions, and shorter DAPT when compared to those of the younger group (all p<0.05).

At 3-month and 1 year more that 92% of older and younger patients were angina free (p=ns). Up to one year, TLF was observed in 5.5% and 2.9% in the older and younger groups, respectively (p<0.001). After propensity matching of the two groups, one-year TLF rate was still significantly higher in older group compared to the younger group (5.4% vs. 3.7%, p<0.001), which was mainly driven by higher incidence of cardiac death (2.9% vs. 1.6%, p<0.001), and target-vessel MI (1.6% vs. 1.0%, p<0.001). There was no difference in CD-TLR (1.9% vs. 1.9%, p=0.74) as well as definite/probable stent thrombosis (0.86% vs. 0.66%, p=0.19). Incidence of bleeding complications was significantly higher in elderly patients (4.4 vs. 2.4%; p<0.001).

Conclusions: In this worldwide registry, the elderly patients showed higher risks of cardiac death, target-vessel MI and bleeding despite shorter duration of DAPT. The incidence of CD-TLR and definite/probable stent thrombosis remained low even in the elderly population.