Clinical Interventions in Aging (Oct 2018)

Differences of patients’ perceptions for elective diagnostic coronary angiography and percutaneous coronary intervention in stable coronary artery disease between elderly and younger patients

  • Rittger H,
  • Frosch B,
  • Vitali-Serdoz L,
  • Waliszewski M

Journal volume & issue
Vol. Volume 13
pp. 1935 – 1943

Abstract

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Harald Rittger,1 Barbara Frosch,1 Laura Vitali-Serdoz,1 Matthias Waliszewski2,3 1Medizinische Klinik 1, Klinikum Fürth, Fürth, Germany; 2Medical Scientific Affairs, B. Braun Melsungen AG, Berlin, Germany; 3Department of Internal Medicine and Cardiology, Charité – Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany Aims: There is limited evidence of the differences in expectations between elderly (≥80 years) and younger patients (<80 years) regarding treatment success of percutaneous coronary interventions (PCI). We conducted a survey in patients undergoing diagnostic coronary angiography (DA) and/or intervention (PCI) to identify differences in patient perceptions between elderly and younger patients.Methods and results: This is an all-comers study of consecutive patients who underwent DA and/or PCI. Patients were asked to fill out a questionnaire prior to DA/PCI. This questionnaire consisted of ten questions with potential patient expectations based on an increasing scale of importance from 0 to 5 which were related to the procedure (eg, extend life, decrease symptoms etc.) and the value of “hard” cardiac endpoints like death, stroke, acute myocardial infarction and target lesion revascularization for the patient. Among 200 patients (mean age 76.6±9.3 years, 60.5% male, ejection fraction 63.7%±13.2%), 100 patients (50%) were ≥80 years. For these elderly patients the questions “to remain independent,” “to maintain mobility, so that I can maintain my current life,” and “to prevent myocardial infarction” were rated highest. Regarding “hard” cardiac endpoints “to avoid PCI in the future” was rated lowest in younger and in elderly patients. Significant differences were found between the age groups with the items “to avoid myocardial infarction,” “avoid heart insufficiency,” “to extend my life” and “to maintain mobility so that I can maintain my current life” (P<0.001).Conclusions: In our survey we found significant differences in patient expectations between elderly and younger patients regarding the outcome of DA/PCI. Keywords: patient perceptions, coronary angiography, percutaneous coronary intervention, elderly

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