背景 台灣人口老化比例正快速增加，本篇為一關於九旬以上老人接受冠狀動脈介入術後之回溯性研究。方法 共計18 位九旬老人進入本研究。其中6 位為藥物治療組 (NM)；12 位為冠狀動脈介入組 (NP)，每位均以同位手術醫師其後連續4 位九十歲以下之病人作為對照組 (CP，n =48)。結果 九旬老人有較多同時存在之慢性病 (p < 0.001)，較常以急性冠心症候群為臨床表現(p < 0.001)，有較多人左心室射出率小於50% (p < 0.001)。與CP 組相較，NP 組則有較高的比例發生非心臟相關之併發症 (p = 0.015)和較長之住院天數 (p = 0.038)。NP 組與CP 組在術後六個月之主要心血管事件發生率上均無差異。值得注意的是，NM 組之患者無論在住院死亡率、術後六個月之主要心血管事件發生率及死亡率上，均有意義的高於NP 組 (p 值分別為0.025、0.004 及0.031)。多變數回歸分析顯示急性冠心症與低左心室射出率在NM組與CP 組扮演重要角色 (p 值分別為0.004 及0.03)，而急性冠心症與糖尿病則在NP 組與CP 組中有顯著差異 (p 值分別為0.02 及0.04)。結論 九旬老人屬高風險族群，冠狀動脈介入術儘管存在較高之非心臟相關併發症，但仍具有不錯之技術成功率與臨床結果。

Background: Elderly people comprise the fast-growing segment of Taiwan’s population. We conducted a retrospective study to analyze the results of PCI in nonagenarians. Methods: 18 nonagenarians were enrolled. Six had medical management only (NM group) and 12 underwent PCI (NP group). Each patient in the NP group was matched with the next 4 consecutive patients (CP group, n = 48) younger than 90 years old and receiving PCI by the same operator. Results: The nonagenarian patients presented more chronic co-morbid diseases (p ＜ 0.001), acute coronary syndrome (p ＜ 0.001), and an LV ejection fraction ＜ 50% (p ＜ 0.001). Although the incidence of cardiac complications didn’t differ between the NP and CP groups, the NP group did have more non-cardiac complications (p = 0.015) and longer post-PCI length of stay (p = 0.038). Major adverse cardiac events (MACE) did not differ between NPand CPgroups in the subsequent 6 months of follow-up. Of note, the in-hospital mortality, MACE and all-cause mortality were higher in NMgroup than in the NPgroup (p = 0.025, 0.004 and 0.031, respectively). Using Cox multivariate proportional hazard regression model, only the presence of acute coronary syndrome and left ventricular ejection fraction ＜ 50% played a role in NM group vs. CP group (hazard ratio 3.42 and 3.07, p = 0.004 and 0.03, respectively), as well, the presence of acute coronary syndrome and diabetes mellitus played a significant role between the NP group and CP group (hazard ratios 2.41 and 2.09, p = 0.02 and 0.04, respectively). Conclusion: Although nonagenarians had a higher incidence of non-cardiac complications, PCI was technically successful and yielded an acceptable outcome.