[Therapeutic attitude after coronariography in elderly patients with ischemic heart disease].
BACKGROUND
The incidence of ischemic heart disease in the elderly is high. These patients are increasing referred for coronariography.


OBJECTIVE
Identify factors associated with coronary revascularization in elderly patients.


METHODS
Retrospective study of 473 patients > or = 75 years who underwent coronariography in relationship with ischemic heart disease. Their clinical-epidemiological characteristics and treatment adopted were analyzed. A multivariate analysis model was used to identify factors associated with revascularization.


RESULTS
Mean age was 77.6 +/- 2.8 years; 70.4% were men. A total of 36% smoked, 53% were hypertensive, 33% diabetics and 30% dislipidemic. Thirty one % had multivessel disease and 11% involvement of left coronary trunk. There was evidence of anterior descending artery in 68%. Medical treatment was done in 48.4%, percutaneous revascularization in 41.5% and surgical in 10.1%. Patients with lesions of the anterior descending artery were revascularized in greater proportion: 67.7% vs 32.3%; p. 0.001. A logistic regression model was used to identify revascularization predictors, obtaining a direct relationship with the involvement of the anterior descending artery (OR: 4.87; 95% CI: 2.98-7.94; (p < 0.001) and inverse on with the previous revascularization (OR: 0.47; 95% CI: 0.26-0.85; p < 0.02), left ventricular dysfunction (OR: 0.58; 95% CI: 0.39-0.88; p = 0.01) and presence of multivessel disease (OR: 0.51; 95% CI: 0.31-0.84; p < 0.01).


CONCLUSIONS
The elderly subjects with ischemic heart disease who underwent coronariography received revascularizing treatment in somewhat more than 50% of the cases. A direct relationship was found between involvement of the anterior descending artery and performance of revascularizing treatment and an inverse on between previous revascularization, left ventricular dysfunction and presence of multivessel disease.
García-Pinilla
J M
JM
Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga. pinilla@secardiolologia.es
Jiménez-Navarro
M F
MF
Gómez Doblas
J J
JJ
Alonso
J H
JH
Hernández García
J M
JM
de Teresa Galván
E
E
D000368:Aged; D001294:Attitude to Health; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000523:psychology / Q000628:therapy; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013030:Spain