{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:11:21Z","timestamp":1791879081600,"version":"4.3.4"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,10,3]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Complex percutaneous coronary intervention (PCI) is increasingly performed in older adults (age \u226575\u2009years) with stable ischemic heart disease. However, little is known about clinical outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We derived a cohort of older adults undergoing elective PCI for stable ischemic heart disease across a large health system. We compared 12\u2010month event\u2010free survival (freedom from all\u2010cause death, nonfatal myocardial infarction, stroke, and major bleeding), all\u2010cause death, target lesion revascularization, and bleeding events for patients receiving complex versus noncomplex PCI and derived risk estimates with Cox regression models. We included 513 patients (mean age, 81\u00b15\u2009years). Patients receiving complex PCI versus noncomplex PCI did not significantly differ across a host of clinical characteristics including cardiovascular disease features, noncardiac comorbidities, guideline\u2010directed medical therapy use, and frailty. Patients receiving complex PCI versus noncomplex PCI experienced worse event\u2010free survival (80.4% versus 86.8%), which was not significant in adjusted analyses (hazard ratio [HR], 1.38 [95% CI, 0.88\u20132.16]). All\u2010cause death at 1 year for patients undergoing complex PCI was nearly double that seen for patients receiving noncomplex PCI (10.2% versus 5.9%), and the risk was significant in models adjusted for clinical characteristics (HR, 1.97 [95% CI, 1.02\u20133.79]). Target lesion revascularization risk was lower for patients receiving complex PCI (2.2% versus 3.5%, adjusted HR), but bleeding events were not statistically different between groups (25.3% versus 20.5%;\n              <jats:italic>P<\/jats:italic>\n              =0.19).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Complex PCI in older adults with stable ischemic heart disease was associated with lower risk of target lesion revascularization but higher all\u2010cause death compared with noncomplex PCI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.029057","type":"journal-article","created":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T10:53:03Z","timestamp":1696071183000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Complex Percutaneous Coronary Intervention Outcomes in Older Adults"],"prefix":"10.1161","volume":"12","author":[{"given":"Jonathan M.","family":"Hanna","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5176-5618","authenticated-orcid":false,"given":"Stephen Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3570-2136","authenticated-orcid":false,"given":"Ajar","family":"Kochar","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Brigham and Women\u2019s Hospital, Harvard Medical School Boston MA USA"},{"name":"Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1486-7452","authenticated-orcid":false,"given":"Dae Yong","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cook County Health Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8774-6416","authenticated-orcid":false,"given":"Abdulla A.","family":"Damluji","sequence":"additional","affiliation":[{"name":"Inova Center of Outcomes Research Falls Church VA USA"},{"name":"Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen A.","family":"Henry","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1364-8055","authenticated-orcid":false,"given":"Yousif","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-0501","authenticated-orcid":false,"given":"Jeptha P.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5745-1636","authenticated-orcid":false,"given":"Michael G.","family":"Nanna","sequence":"additional","affiliation":[{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.283.5403.796"},{"key":"e_1_3_1_3_2","first-page":"1","article-title":"Deaths: leading causes for 2019","volume":"70","author":"Heron M","year":"2021","unstructured":"Heron M. 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