|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1998; 32:577-583 © 1998 by the American College of Cardiology Foundation |
a Centro Cuore Columbus, Milan, Italy
Manuscript received February 12, 1998; revised manuscript received May 6, 1998, accepted May 20, 1998.
Address for correspondence: Dr. Antonio Colombo, Centro Cuore Columbus via M. Buonarroti 48, 20145 Milan, Italy
Objectives. This study sought to compare the short- and long-term outcomes of elderly patients undergoing coronary artery stenting with those of younger patients and to determine the long-term clinical outcome and survival of elderly patients post stent implantation.
Background. Elderly patients undergoing coronary revascularization are considered a high-risk group. Few data exist that relate the results of stenting in treating coronary artery disease in the elderly population.
Methods. All elderly patients 
75 years of age who underwent coronary artery stenting between March 1993 and July 1997 (n = 137) at our center were compared to the patients <75 who underwent coronary artery stenting during the same time period (n = 2,551). Long-term clinical follow-up and survival were determined for the elderly group.
Results. Elderly patients presented with lower ejection fractions (54% vs. 58%, p = 0.0001), more unstable angina (47% vs. 28%, p = 0.0001), and more multivessel disease (78% vs. 62%, p = 0.0001) than younger patients. These older patients had higher rates of procedure related complications including procedural myocardial infarction (MI) (2.9% vs. 1.7%, p = 0.2), emergency CABG (3.7% vs. 1.4%, p = 0.04), and death (2.2% vs. 0.12%, p = 0.0001). Angiographic follow-up, obtained in both groups, demonstrated significantly higher restenosis rates in the elderly versus younger patients (47% vs. 28%, p = 0.0007). Longer term clinical follow-up, which was obtained only in the elderly group, showed that at a mean follow-up period of 12 months post coronary stenting, elderly survival free from death, MI, revascularization and angina was 54% and that their overall survival was 91%. Subanalysis of the elderly patients who died showed much higher incidence of combined unstable angina (80%), prior MI (60%), lower ejection fraction (46%), multivessel disease (100%) and complex lesions (100%) than the overall group.
Conclusions. Elderly patients who undergo coronary artery stenting have significantly higher rates of procedural complications and worse six month outcomes than younger patients, especially those who present with combined unstable angina, history of MI, EF < 50%, multivessel disease and complex lesions. Overall survival in the elderly population at 12 months postcoronary artery stenting was 91% and event-free survival was 54%.
| ||||||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  B. W. Ullery, J. C. Peterson, F. Milla, M. T. Wells, W. Briggs, L. N. Girardi, W. Ko, A. J. Tortolani, O. W. Isom, and K. H. Krieger Cardiac Surgery in Select Nonagenarians: Should We or Shouldn't We? Ann. Thorac. Surg., March 1, 2008; 85(3): 854 - 860. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Dacey, D. S. Likosky, T. J. Ryan Jr, J. F. Robb, R. D. Quinn, J. T. DeVries, M. J. Hearne, B. J. Leavitt, R. F. Dunton, R. A. Clough, et al. Long-Term Survival After Surgery Versus Percutaneous Intervention in Octogenarians With Multivessel Coronary Disease Ann. Thorac. Surg., December 1, 2007; 84(6): 1904 - 1911. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Palmerini, F. Barlocco, A. Santarelli, L. Bacchi-Reggiani, C. Savini, E. Baldini, L. Alessi, M. Ruffini, G. Di Credico, G. Piovaccari, et al. A comparison between coronary artery bypass grafting surgery and drug eluting stent for the treatment of unprotected left main coronary artery disease in elderly patients (aged >=75 years) Eur. Heart J., November 2, 2007; 28(22): 2714 - 2719. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-E. Hassani, G. S. Mintz, H. S. Fong, S.-W. Kim, Z. Xue, A. D. Pichard, L. F. Satler, K. M. Kent, W. O. Suddath, R. Waksman, et al. Negative Remodeling and Calcified Plaque in Octogenarians With Acute Myocardial Infarction: An Intravascular Ultrasound Analysis J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2413 - 2419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Liistro, K. Ducci, G. Falsini, and L. Bolognese Early invasive strategy in elderly patients with non-ST-elevation acute coronary syndromes Eur. Heart J. Suppl., October 1, 2005; 7(suppl_K): K23 - K25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kaiser, G. M. Kuster, P. Erne, W. Amann, B. Naegeli, S. Osswald, P. Buser, H. Schlapfer, W. Brett, H.-R. Zerkowski, et al. Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina - on-treatment analysis of the TIME trial Eur. Heart J., June 2, 2004; 25(12): 1036 - 1042. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Halon, S. Adawi, I. Dobrecky-Mery, and B. S. Lewis Importance of increasing age on the presentation and outcome of acute coronary syndromes in elderly patients J. Am. Coll. Cardiol., February 4, 2004; 43(3): 346 - 352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Ascione, K. Rees, K. Santo, M.H. Chamberlain, G. Marchetto, F. Taylor, and G.D. Angelini Coronary artery bypass grafting in patients over 70 years old: the influence of age and surgical technique on early and mid-term clinical outcomes Eur. J. Cardiothorac. Surg., July 1, 2002; 22(1): 124 - 128. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. S. Chauhan, R. E. Kuntz, K. K. L. Ho, D. J. Cohen, J. J. Popma, J. P. Carrozza Jr, D. S. Baim, and D. E. Cutlip Coronary artery stenting in the aged J. Am. Coll. Cardiol., March 1, 2001; 37(3): 856 - 862. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Kimmel, A. R. Localio, C. Brensinger, C. Miles, J. Hirshfeld, H. L. Haber, and B. L. Strom Effects of Coronary Stents on Cardiovascular Outcomes in Broad-Based Clinical Practice Arch Intern Med, September 25, 2000; 160(17): 2593 - 2599. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. C. Koutlas, J. R. Elbeery, J. M. Williams, J. F. Moran, N. A. Francalancia, and W. R. Chitwood Jr Myocardial revascularization in the elderly using beating heart coronary artery bypass surgery Ann. Thorac. Surg., April 1, 2000; 69(4): 1042 - 1047. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Pump, S. Möhlenkamp, C. A. Sehnert, S. S. Schimpf, A. Schmidt, R. Erbel, D. H. W. Grönemeyer, and R. M. M. Seibel Coronary Arterial Stent Patency: Assessment with Electron-Beam CT Radiology, February 1, 2000; 214(2): 447 - 452. [Abstract] [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
