Coronary stent implantation in patients older than 75 years of age: clinical profile and initial and long-term (3 years) outcome.
OBJECTIVE
The objective of this study was to compare the initial and long-term outcome of elderly and younger patients after coronary stent implantation.


METHODS
The evolutions of 76 patients aged >75 years and of 860 patients aged < or =75 years who underwent consecutive stenting (from June 1991 to June 1997) were compared in a cohort study.


RESULTS
The elderly patients had lower left ventricular ejection fractions (0.58 +/- 0.14 vs 0.61 +/- 0.13; P =.03) and more frequently had unstable angina (78.9% vs 55.3%; P <.0001), previous heart failure (10.5% vs 4.9%; P =.03), and multivessel disease (68.4% vs 58.3%; P =.08). After the procedure, the elderly patients showed a higher inhospital mortality rate (6.6% vs 2.4%; P =.03) and myocardial infarction rate (5.3% vs 1.7%; P =.04). The long-term follow-up period (mean, 3.2 +/- 1.4 years; median, 3.0 years) showed in the elderly a higher mortality rate (15.4% vs 5.8%; P =.006), a lower rate of repeat revascularization (9.2% vs 19.7%; P =.04), and a similar incidence rate of major adverse cardiac events (27.7% vs 28.2%; P =.93). Multivariate analysis of the elderly group identified female gender (hazard ratio, 2.19; 95% CI, 1.18 to 4.06; P =.012) and presence of multivessel disease (hazard ratio, 2.35; 95% CI, 1.05 to 5.26; P =.037) as independent predictors of further events.


CONCLUSIONS
Patients aged >75 years have a less favorable baseline profile and higher inhospital and 3-year mortality rates. However, the incidence rate of major adverse cardiac events in the long term is acceptable and similar to that of younger patients.
Muñoz
Juan C
JC
Institute of Heart Science (ICICOR), Hospital Universitario de Valladolid, Valladolid, Spain. jsanjose@scisquemica.org
Alonso
Joaquín J
JJ
Duran
Juan M
JM
Gimeno
Federico
F
Ramos
Benigno
B
Garcimartin
Isabel
I
de la Fuente
Luis
L
Gomez
Itziar
I
Fernandez-Aviles
Francisco
F
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D015607:Stents / Q000009:adverse effects; D013318:Stroke Volume; D016896:Treatment Outcome