Long-term clinical outcome of coronary artery stenting in elderly patients.
BACKGROUND
The elderly constitute a rapidly expanding segment of our population and cardiovascular disease becomes more prevalent with increasing age. Existing data have shown that percutaneous coronary interventions in the elderly are associated with an increase risk of in-hospital complications compared to younger patients. In the present study we retrospectively assessed the long-term clinical outcome of coronary artery stenting in an elderly population and compared them with the cohort of younger patients.


METHODS
The study population included 402 consecutive patients with coronary artery disease who underwent coronary artery stenting; of these 69 were elderly (age > 70 years, group I) and 333 were younger (age <or= 70 years, group II). Percutaneous coronary intervention combined with stent implantation was performed using standard techniques. Clinical outcomes during follow-up (24 +/- 13 months, range 7-56 months) were obtained in all patients without major in-hospital complications. Survival curves and multivariate Cox proportional hazard models for any late clinical event were reported.


RESULTS
No difference in in-hospital complications or clinical success rate was observed between the two groups of patients. Complete revascularization was obtained more frequently in younger compared to elderly patients (P < 0.05). At 2 years, event-free survival was 62% in the elderly and 76% in younger patients (P < 0.001); this difference was mostly made-up by recurrence of angina in the elderly. Impaired left ventricular systolic function (ejection fraction < 40%) was an independent predictor of late death.


CONCLUSIONS
Coronary artery stenting is an effective therapeutic strategy in elderly with coronary artery disease and is associated with good short- and long-term results. Age per se should not preclude patients from undergoing coronary stenting.
Voudris
Vassilis A
VA
First Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece. vvoudris@otenet.gr
Skoularigis
John S
JS
Malakos
John S
JS
Kourgianides
George C
GC
Pavlides
Gregory S
GS
Manginas
Athanasios N
AN
Kolovou
Genovefa D
GD
Cokkinos
Dennis V
DV
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D015331:Cohort Studies; D023921:Coronary Stenosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013318:Stroke Volume / Q000502:physiology; D013995:Time; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology