title: Impact of age on procedural and 1-year outcome in percutaneous transluminal coronary angioplasty: a report from the NHLBI Dynamic Registry.
abstract: BACKGROUND
  Older age has been associated with adverse outcomes in patients undergoing percutaneous coronary intervention (PCI). As PCI technology evolves and the US population becomes proportionally older, assessment of PCI in older age groups is essential.
  
  
  METHODS
  From the National Heart, Lung, and Blood Institute Dynamic Registry, 4620 PCI-treated patients (1997 to 1999) were studied. Differences in clinical presentation, treatment strategy, and inhospital and 1-year outcomes were compared between patient age groups: younger (<65 years, n = 2537); older (65 to 79 years, n = 1776); and elderly (> or =80 years, n = 307).
  
  
  RESULTS
  Older and elderly patients had more cardiac and comorbid noncardiac conditions and more extensive and complex arteriosclerosis, including stenoses in bypass grafts. Stent use was similar as age increased (72% vs 73% vs 73%), as was the use of IIb/IIIa receptor antagonists (29% vs 26% vs 28%). Rates of successful treatment of all attempted lesions were 93%, 92%, and 89%, respectively. Adjusted relative risks of inhospital death (1.0 vs 2.91 vs 3.64) and myocardial infarction (1.0 vs 1.35 vs 2.57) increased by age group, as did 1-year mortality rates (1.0 vs 1.87 vs 3.02). However, the relative magnitude of excess mortality rates at 1 year was comparable to that observed by age in the US general population. Age was not associated with 1-year risk of myocardial infarction or coronary artery bypass grafting.
  
  
  CONCLUSIONS
  Although new technologies may allow for treatment of complex disease in older and elderly patients with comorbid disease, the increased procedural risk remains substantial in these patients. After PCI, the long-term relative risk of death is similar to that expected among persons of similar ages in the general population.
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, Pa, USA.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Cohen
authors.forename: David O
authors.initials: DO
authors.lastname: Williams
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.forename: Faith
authors.initials: F
authors.lastname: Selzer
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Janet M
authors.initials: JM
authors.lastname: Johnston
authors.forename: Richard
authors.initials: R
authors.lastname: Holubkov
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Detre
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D002423:Cause of Death; D003327:Coronary Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D012042:Registries; D013223:Statistics as Topic; D015912:Thrombolytic Therapy; D016896:Treatment Outcome