ArticleCardiology and therapy2026
In-Hospital and 1-Year Outcomes of Octogenarian and Nonagenarian Patients with Severely Calcified Coronary Lesions Treated with Rotational Atherectomy.
Article in Cardiology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSeverely calcified coronary lesions are a common challenge in older percutaneous coronary intervention (PCI) populations. We aimed to investigate in-hospital and 1-year outcomes of octogenarian and nonagenarian patients with heavily calcified coronary lesions treated with rotational atherectomy (RA).
methodsPatients who underwent RA at our center were divided into two groups: octogenarians/nonagenarians (age ≥ 80 years) (n = 194) and younger counterparts (age < 80 years) (n = 591). Patients presented with acute coronary syndrome, and those treated with bare-metal stents were excluded. At 1 year, major adverse cardiac events (MACE) were investigated as a composite of cardiac death, spontaneous myocardial infarction (MI), or target lesion revascularization (TLR).
resultsIn-hospital adverse outcome rates were 10.3% in the octogenarian/nonagenarian group versus 13.5% in the younger group (p = 0.266). Notably, the octogenarian/nonagenarian group had numerically higher in-hospital mortality (2.1% vs. 0.5%, p = 0.067). However, after adjusting for potential confounders, in-hospital mortality did not differ significantly between study arms (adj. HR 3.68; 95% CI 0.69-19.5, p = 0.126). At 1 year, the octogenarian/nonagenarian group was associated with a higher MACE rate (20% vs. 13%, adj. HR 1.78; 95% CI 1.27-2.50, p = 0.001), which was driven mainly by more cardiac deaths (13% vs. 4%, log-rank p < 0.001). Rates of MI (log-rank p = 0.708) and TLR (log-rank p = 0.333) were comparable between both study arms.
conclusionsRA is feasible in octogenarian and nonagenarian patients, with in-hospital adverse outcomes comparable to those of younger patients. Advanced age remains a strong predictor of 1-year MACE, given its inherently higher mortality. Graphical abstract available for this article.
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