Safety and efficacy of coronary drug-eluting stents in octogenarians.
OBJECTIVE
The effectiveness of coronary drug-eluting stents has not been fully studied in very elderly patients who have clinical features that predispose them to side effects and long-term adverse events.


METHODS
The safety and efficacy of drug-eluting stents were studied in a historical cohort of consecutive octogenarian patients who underwent percutaneous coronary intervention.


RESULTS
Between 2002 and 2006, 176 octogenarian patients were treated using coronary stents: 90 with drug-eluting stents and 86 with bare-metal stents only. Patients treated using drug-eluting stents had a greater number of diseased vessels (2.28+/-0.85 vs. 1.87+/-0.87; P=.002), had more vessels treated (1.74+/-0.79 vs. 1.17+/-0.47; P< .0005), were more likely to have multivessel disease (79% vs. 59%; P=.005) and to undergo left main coronary artery treatment (20% vs. 1.0%; P< .0005), and had longer (26.6+/-6.7 mm vs. 16.6+/-4.9 mm; P< .0005) and smaller diameter (2.91+/-0.4 mm vs. 3.04+/-0.4 mm; P=.049) lesions. The median follow-up period was 26.3+/-12.9 months (in 98.3% of patients). After adjustment for other variables and for the likelihood of receiving a drug-eluting stent (i.e., the propensity score), there was no significant relationship between the type of coronary stent used and either mortality or the occurrence of adverse clinical events at 1 year of follow-up.


CONCLUSIONS
With careful clinical selection of patients, the use of drug-eluting stents in octogenarians with highly unfavorable angiographic characteristics can be as safe and effective as conventional stents for treating low-risk coronary lesions.
López-Palop
Ramón
R
Servicio de Cardiología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, Spain. mlopezs@meditex.es
Carrillo
Pilar
P
Frutos
Araceli
A
Cordero
Alberto
A
Núñez
Daniel
D
Toro
Marlon
M
Bertomeu-Martínez
Vicente
V
D000367:Age Factors; D000369:Aged, 80 and over; D023921:Coronary Stenosis / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies