Percutaneous coronary intervention ( PCI) is safe and effective in very elderly patients, defined as those who are age ≥85 years, with acute coronary syndrome ( ACS). However, the prognostic factors remain unknown. The association between activities of daily living ( ADL) and the prognosis after PCI has not yet been investigated.
This retrospective study included 91 consecutive very elderly patients with ACS. We calculated the Barthel Index ( BI) as an indicator for ADL. Patients were classified into 2 groups according to BI: high BI (≥85) and low BI (<85). The BI was assessed both on admission (pre‐ BI) and at discharge (post‐ BI).
In the 91 patients (mean age, 88.2 ± 3.0 years, 52% male), 1‐year mortality was 33%. The Cox regression model demonstrated that low pre‐ BI was not a risk factor for 1‐year mortality (hazard ratio: 0.73, 95% confidence interval [ CI]: 0.30‐1.78, P = 0.490). However, post‐ BI was significantly associated with 1‐year mortality (hazard ratio: 0.25, 95% CI: 0.11‐0.57, P = 0.001). The 1‐year mortality of the high and the low post‐ BI group was estimated as 21% (95% CI: 12%‐35%) and 62% (95% CI: 42%‐82%), respectively. A 5‐unit decrease in post‐ BI was related to a 1.10‐fold increased risk for 1‐year mortality (95% CI: 1.05‐1.15, P < 0.001).