[Results of coronary heart disease treatment with coronary angioplasty in patient over 65].
The aim of the study was to investigate the results of coronary angioplasty in patients over 65 years old.


METHODS
Among the following 590 patients after coronary angiography performed in the Department of Cardiology, Institute of Cardiology Medical University of Łódz 113 (19.2%) pt were over 65 years old (mean age 69.4 years) and 477 (80.8%) pt in the age below 65 years old (mean age 51.6 years). Coronary angioplasty underwent 31 patients (27.4%) over 65 years old and which were the study group and 207 (43.4%) pt below 65 years old and which were the control group.


METHODS
The frequency of previous MI, CCS angina class, the results of coronary angiography and qualification for percutaneous transluminal coronary angioplasty treatment, the percent of successful and complete revascularisation, the number of clinical restenosis and restenosis in angiography and the methods of restenosis treatment were estimated. In statistical analysis Chi-square test and t-Student test were used.


RESULTS
Three vessels disease in angiography was observed more frequently in pt over 65 years old than in the younger group (40.7% vs 26.6%; p < 0.005) and these pt were qualified more frequently to surgery revascularisation 37.2% (vs 22% in younger ones; p < 0.001) while the coronary angioplasty was performed only in 27.4% pt (vs 43.4% in younger ones; p < 0.005). Successful angioplasty was performed in almost 97 percent of patients in both groups. The frequency of complete revascularization was significantly lower in patients over 65 years old than in the control group (36.7% vs 57.9%, p < 0.05) because of the more advanced coronary lesions in older ones. Angioplasty with stent implantation was performed in 29% pt over 65 and in 27% pt below 65 years old. On the basis of clinical evidence of ischemia (mainly recurrent angina) restenosis was suspected in 36.7% of older and in 29.7% of younger patients but the difference wasn't statistically significant. Angiographic analysis revealed restenosis after coronary balloon angioplasty in 33.3% patients over 65 years old and in 21.3% of younger ones. Stenosis in stents was observed in 13.3% of older and in 6.4% of younger patients. Restenosis was treated with coronary artery bypass grafting in about 20% and with percutaneous revascularization in 80% of patients in both groups. In patients over 65 years old the frequency of using intracoronary stents during revascularization was lower than in the control group (10% vs 30%).


CONCLUSIONS
1. In patients over 65 years old the frequency of using angioplasty as the method of revascularization was lower than in younger patients. 2. Although complete revascularization can be instituted only in half of the patients over 65 years old, the results of coronary angioplasty are not worse than in younger people.
Chizyński
Krzysztof
K
Instytut Kardiologii AM 91-425 Łódź, ul. Sterlinga 1/3. kchizyn@poczta.onet.pl
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome