Analysis of risk factors for chronic total occlusion, multi-vessel and trunk of left coronary artery involvement in patients aged over 70 undergoing PCI
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Central Clinical Hospital, Warsaw / Medical University, Warsaw, Poland
University Clinical Hospital, Poznań, Poland
Międzyleski Specialist Hospital / Medical University, Warsaw, Poland
Southern Hospital, Warsaw-Ursynów, Poland
I Department and Clinic of Cardiology, Medical University, Warsaw, Poland
Corresponding author
Jakub Kuciński   

Central Clinical Hospital in Warsaw, Medical University, Warsaw, Poland
Introduction and objective:
Percutaneous coronary intervention (PCI) is a non-surgical, invasive procedure used to unblock significantly narrowed coronary arteries in coronary artery disease. Elderly patients who require PCI are often burdened by a medical history. For these patients, percutaneous coronary intervention is a procedure with a significantly increased risk. In addition, several forms of coronary artery disease, such as multi-vessel disease, chronic total occlusion (CTO) or left coronary artery trunk disease, are considered ‘high-risk PCI’.

Material and methods:
An investigator-initiated, retrospective, single-centre study conducted between 11.2020–12.2021 in the 1st Department of Cardiology of the Medical University of Warsaw involving 150 patients over 70 years of age undergoing PCI. The performance of angioplasty, as recommended by the ESC guidelines, depended on the choice of the interventional cardiologist in the case of acute coronary syndrome, or on the decision of the Heart Group in the case of elective procedure, and subject to the patient’s informed consent. Exclusion criteria included age <70 years.

Comorbidities, such as diabetes, chronic kidney disease, high BMI and male gender, appear to be the main risk factors for complex PCI.

The study showed that old age alone was not a significant risk factor for the need for a complex PCI procedure. There were no significant differences in the incidence of left coronary artery trunk disease, multi-vessel disease or chronic total occlusion between the age groups analysed. However, the group of patients who required ‘highrisk PCI’ had various co-morbidities, such as type 2 diabetes, chronic kidney disease or a higher BMI score.

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