“What’s been shown in multiple studies over the years is that chronological age alone should not be an exclusion to performing percutaneous coronary intervention in appropriately selected patients,” said Dr. Adam Skolnick of NYU Langone Medical Center in New York who specializes in geriatric cardiology.
“The study confirms that in appropriately selected patients the procedure can be performed safely with a low risk of complications,” he told Reuters Health in a telephone interview.
About half of the nonagenarians in the study had PCI on an emergency basis to treat a heart attack, he noted. “If someone is in the throes of a myocardial infarction, time is of the essence,” Skolnick said. “Usually unless there’s a really strong contraindication we would proceed with PCI.”
But for non-emergency situations, for example to treat chest pain, “I think these are individual decisions that should not be based on simple risk scores. They have to include a discussion between the patient and/or caregiver and the treating doctors,” Skolnick said.
The patient’s goals should be central to any decisions made about whether to undergo PCI, he added, and if that goal is to live longer, it’s not clear that non-emergency PCI will extend life in this age group.