Impact of age on the outcomes of women following percutaneous coronary intervention in the bare-metal stent era.
OBJECTIVE
Advanced age and female gender are both independent predictors of early and late mortality and adverse cardiac outcomes for patients undergoing balloon angioplasty. Elderly women are at particular risk. Stenting is now the standard of care in PCI. Whether elderly women remain at increased risk after PCI in the current stent era has not been examined widely.


METHODS
Prospective data were collected in 400 consecutive female patients undergoing PCI at a tertiary cardiac center (1999-2003). Follow-up was done at 1 month, 6 months, and 12 months by clinic visits, telephonic interviews, and reviewing hospital records. Follow-up was complete in 396 patients.


RESULTS
Compared to young women (<65 years old), elderly women (>65 years old) were less likely to smoke (15.7% vs 47.2%, P = 0.001), less likely to have diabetes (4.1% vs 8.5%, P = 0.05), and had more multivessel coronary artery disease. Usage of stent was high, similar in both groups. Hypertension, hypercholesterolemia, previous MI, vessels treated, abciximab usage, and access site bleeding were similar in both groups. Procedural success (96% vs 98%) and in-hospital and 1-year MACE (23.1% vs 25%) are similar in both groups.


CONCLUSIONS
Elderly women undergoing PCI have a distinct profile presenting with more multivessel disease, less smoking, and are less likely to have diabetes than younger women. In the current stent era, procedural success, in-hospital adverse cardiac events, and MACE at 1 year are similar in both groups. At 1 year, however, elderly women are less likely to have ischemia-driven TVR and recurrence of angina.
Rathore
Sudhir
S
Department of Cardiology, The Cardiothoracic Centre, Liverpool, UK. sudhirrathore@hotmail.com
Rhys
Julie
J
Buchalter
Maurice B
MB
Gerning
Nick O
NO
Groves
Pete H
PH
Penny
William
W
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking; D015607:Stents; D016896:Treatment Outcome