Prognostic Value of Osteoporosis in Elderly Patients with Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Objective To investigate the impact of osteoporosis on the prognosis of elderly patients with stable coronary artery disease (CAD) after percutaneous coronary intervention (PCI). Methods This study included 215 patients diagnosed with stable CAD, who were divided into an osteoporosis group (n = 92) and a non-osteoporosis group (n = 123) based on their bone mineral density (BMD) T-scores. Clinical characteristics between the two groups were compared. Multivariate Cox regression analysis was used to assess the impact of osteoporosis on major adverse cardiovascular events (MACE). Kaplan-Meier curves were used for survival analysis, and Pearson correlation analysis was performed to examine the relationship between bone metabolism markers and MACE. Results The study showed that patients in the osteoporosis group were older and had a higher proportion of females. The osteoporosis group had significantly higher levels of bone metabolism markers (osteocalcin, PICP, PINP), a higher proportion of three-vessel disease, and a higher incidence of MACE compared to the non-osteoporosis group ( P  < 0.05). Multivariate Cox regression analysis revealed that osteoporosis was an independent risk factor for MACE (HR = 1.80, 95% CI: 1.08–2.98). Kaplan-Meier curves demonstrated a higher incidence of MACE in the osteoporosis group compared to the non-osteoporosis group (Log-Rank χ ²  = 14.20, P  < 0.001). Pearson correlation analysis found that BMD was negatively correlated with MACE (r=-0.328, P  < 0.001), while osteocalcin, PICP, and PINP were positively correlated with MACE (r = 0.415, 0.394, 0.367, respectively, all P  < 0.001). Conclusion Elderly patients with stable CAD and osteoporosis have an increased risk of MACE after PCI. Decreased bone mineral density and abnormal bone metabolism markers can serve as predictors of poor prognosis in these patients.