Percutaneous coronary angioplasty in patients over 75 years old: immediate and mid-term results.
Ninety-five patients 75 years or older (range 75-90, mean 79) underwent PTCA from 1987 to 1991.  Forty-two patients were 80 years or older. Forty-four had prior MI, 5% had prior coronary bypass surgery (CBS), 13% had a prior history of recent cardiac failure, and 81% (77/95) presented with unstable angina, refractory to intravenous treatment in 31 cases. The mean left ventricular ejection fraction was 62% (range 34%-80%). Thirty-nine percent had single vessel disease, 41% had two vessel disease, and 20% had three vessel disease.  Coronary calcifications were present in 28%.  A single vessel was dilated in 81 patients, two vessels in 14 patients; complete revascularization was achieved in 41%.  The clinical angiographic primary success rate was 79% (75/95).  There were five procedural deaths, five MI, five CBS and, ten hematomas.  Follow-up data were obtained in 100% cases, with a mean follow-up duration of 12 months (ranging from 1-36).  There were four deaths, one MI, and two CBS.  Twenty percent (15/74) of patients had a second PTCA with a 73% success rate.  Finally, 70% of the initial population was asymptomatic after first or second PTCA at mid-term follow-up.  We conclude that PTCA is safe and effective in elderly patients, with 70% clinical success rate at mid-term follow-up in spite of frequent incomplete revascularization limited to the culprit lesion.
Gueniche
C
C
Hôpital Béclère, Clamart, France.
Tabone
X
X
Slama
M S
MS
Metzger
J P
JP
Motté
G
G
Vacheron
A
A
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D003327:Coronary Disease / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome