title: Acute and long-term results of coronary stents and atherectomy in women and the elderly.
abstract: OBJECTIVE
  To determine the efficacy of new coronary interventions in women and the elderly.
  
  
  METHODS
  We studied 504 patients who underwent a total of 567 procedures, comprising 275 directional coronary atherectomy and 292 Palmaz-Schatz stents over a 2 1/2 year period; 18% were women and 23% were aged > or = 70 years (elderly).
  
  
  RESULTS
  High rates of success were obtained with these procedures in women and the elderly, although the rates were lower in women than in men (89 versus 96%, P = 0.005), and similarly lower in the elderly than in younger patients (91 versus 96%, P = 0.06). In addition to the lower success rates, there was a higher incidence of procedure-related non-Q myocardial infarction and vascular complications in both the women and the elderly, independently. The degree of angiographic restenosis (> or = 50% diameter stenosis), however, was similar in women (36 versus 28% in men, P = 0.22) and in the elderly (28 versus 29% in patients ages < 70 years, P = 0.8). There were no sex-related differences in survival, late myocardial infarction, or repeat revascularization. In the elderly, although the incidence of repeat revascularization was not increased, there was a decrease in late survival (P < 0.001) and an increase in the incidence of late myocardial infarction (P = 0.02), probably reflecting the presence of other co-morbid variables.
  
  
  CONCLUSIONS
  Both directional coronary atherectomy and coronary stenting can be performed safely and effectively in women and the elderly with good long-term clinical results, despite a somewhat lower rate of success and similarly higher rates of acute complications.
authors.affiliation: Charles A. Dana Research Institute, Boston, Massachusetts, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Fishman
authors.forename: R E
authors.initials: RE
authors.lastname: Kuntz
authors.forename: J P
authors.initials: JP
authors.lastname: Carrozza
authors.forename: S P
authors.initials: SP
authors.lastname: Friedrich
authors.forename: P C
authors.initials: PC
authors.lastname: Gordon
authors.forename: C C
authors.initials: CC
authors.lastname: Senerchia
authors.forename: D S
authors.initials: DS
authors.lastname: Baim
mesh_terms: D000367:Age Factors; D000368:Aged; D017225:Atherectomy, Coronary / Q000009:adverse effects; D017023:Coronary Angiography; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012737:Sex Factors; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate