title: Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry.
abstract: OBJECTIVE
  The aim of this study was to identify the worldwide practice of Cypher Select (Cordis Corporation, Bridgewater, New Jersey) or Cypher Select Plus sirolimus-eluting stent (SES) in patients 80 years of age (octogenarian) and to identify clinical outcomes in this patient population.
  
  
  BACKGROUND
  The use of drug-eluting stents in elderly patients may have different features compared with younger patients.
  
  
  METHODS
  Between 2006 and 2008, 15,147 patients from 320 hospitals in 56 countries were enrolled in a registry. Initial implantation and follow-up outcome information obtained at 1-year follow-up in 675 octogenarian patients were compared with those in 14,472 nonoctogenarian patients.
  
  
  RESULTS
  Octogenarians had significantly more comorbidities and had higher Charlson comorbidity index scores (1.5 ± 1.6 vs. 1.0 ± 1.3, p < 0.001). Rates of cardiac death (3.3% vs. 0.9%, p < 0.001), myocardial infarction (2.3% vs. 1.9%, p = 0.021), and definite or probable stent thrombosis (2.3% vs. 0.9%, p = 0.0002), and major bleeding (2.0% vs. 0.9%, p = 0.015) were significantly higher in octogenarians at 1 year; however, there was no significant difference in the rate of target lesion revascularization between the 2 groups (3.2% vs. 2.2%, p = 0.12). In octogenarians, a high Charlson comorbidity index was an independent predictor of death and stent thrombosis up to 360 days from the index procedure (hazard ratio: 1.3, 95% confidence interval: 1.1 to 1.5, p < 0.001, and hazard ratio: 1.5, 95% confidence interval: 1.3 to 1.8, p < 0.001, respectively).
  
  
  CONCLUSIONS
  Stenting with SES may be an effective therapeutic option in elderly patients, with acceptable rates of complications and a very low rate of repeat revascularization as demonstrated by this e-SELECT (A Multi-Center Post-Market Surveillance Registry) subgroup analysis.
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Alexander
authors.initials: A
authors.lastname: Abizaid
authors.forename: Adrian
authors.initials: A
authors.lastname: Banning
authors.forename: Antonio
authors.initials: A
authors.lastname: Bartorelli
authors.forename: Vladimir
authors.initials: V
authors.lastname: Dzavik
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Ellis
authors.forename: Runlin
authors.initials: R
authors.lastname: Gao
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.forename: Victor
authors.initials: V
authors.lastname: Legrand
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Christian
authors.initials: C
authors.lastname: Spaulding
authors.forename: Stephen
authors.initials: S
authors.lastname: Worthley
authors.forename: Philip
authors.initials: P
authors.lastname: Urban
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D001315:Australia; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D054855:Drug-Eluting Stents; D005060:Europe; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D020407:Internet; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009656:North America; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011358:Product Surveillance, Postmarketing; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage*; D013020:South America; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D020123:Sirolimus