Outcome in the elderly undergoing percutaneous coronary intervention with sirolimus-eluting stents: results from the prospective multicenter German Cypher Stent Registry.
BACKGROUND
Patients older than 75 years undergoing percutaneous coronary interventions are at increased risk for major adverse cardiac events strongly influenced by comorbidities. In various randomized trials, sirolimus-eluting stent (SES) implantation has been shown to decrease the incidence of in-stent restenosis and to reduce repeat revascularization regardless of patient age.


METHODS
The present study evaluates the outcome after SES implantation in 954 patients older than 75 years compared with 5801 patients younger than 75 years enrolled in the German Cypher Registry in a routine clinical setting.


RESULTS
The elderly were at higher risk regarding renal failure, diabetes, hypertension, impaired left ventricular function, and 3-vessel disease. The SES implantation resulted in an impressive relief of angina. As expected, in-hospital and 6-month mortality rates were higher in the elderly. However, there was no difference with respect to the rate of major adverse cardiac events (death, myocardial infarction, ischemia-driven target vessel revascularization) at 6-month follow-up.


CONCLUSIONS
Nonfatal complications such as myocardial infarction or repeat target vessel revascularization did not increase with age, even taking patients older than 80 years into account.
Wiemer
Marcus
M
Heart and Diabetes Center, North Rhine Westfalia, University Bochum, Bad Oeynhausen, Germany.
Langer
Christoph
C
Kottmann
Tanja
T
Horstkotte
Dieter
D
Hamm
Christian
C
Pfannebecker
Thomas H
TH
Tebbe
Ulrich
U
Schneider
Steffen
S
Senges
Jochen
J
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015897:Comorbidity; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus