title: Are the elderly different? Factors influencing mortality after percutaneous coronary intervention with stent implantation.
abstract: BACKGROUND
  The aim of this study was to investigate factors influencing mortality after percutaneous coronary intervention (PCI) in patients aged ≥ 75 years compared to younger patients.
  
  
  METHODS
  A total of 1,809 coronary heart disease (CHD) patients after PCI with stent implantation in our hospital were assessed. Kaplan-Meier analyses with log-rank test and Cox regression analyses were performed on three predefined models concerning primary endpoint of all-cause mortality. Model 1 was a univariate analysis of the influence of age dichotomized by age 75 years on the primary endpoint. Model 2 included age and classical cardiovascular risk factors (CVRFs, e.g., body mass index (BMI), smoking, diabetes, and hypertension). Model 3 consisted of age, classical CVRFs, and additional factors (e.g., medication; hemoglobin, peripheral arterial disease (PAD), low-density lipoprotein cholesterol (LDL-C) and creatinine levels, and left ventricular ejection fraction (LVEF)).
  
  
  RESULTS
  In the mean follow-up of 137 ± 61 weeks 375 patients died. Age ≥ 75 years was significantly related to mortality in all models. In model 3, previous stroke, PAD, diabetes, elevated levels of serum creatinine, and increased LDL-C were related to elevated mortality, higher hemoglobin levels, and LVEF > 50% were associated with decreased mortality in all patients and in patients < 75 years. In patients ≥ 75 years arterial hypertension was associated with poor outcome (hazard ratio (HR) 7.989, p = 0.040), previous antiplatelet therapy showed reduced mortality (HR 0.098, p = 0.039).
  
  
  CONCLUSIONS
  Although risk factors such as previous stroke, PAD, diabetes, renal insufficiency, and anemia were predictors for death in all patients and patients < 75 years, in the elderly only arterial hypertension increased, whereas treatment with platelet inhibitors decreased mortality.
authors.affiliation: Universitätsklinik und Poliklinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Germany. jochen.schroeder@medizin.uni-halle.de
authors.forename: J
authors.initials: J
authors.lastname: Schröder
authors.forename: U
authors.initials: U
authors.lastname: Müller-Werdan
authors.forename: S
authors.initials: S
authors.lastname: Reuter
authors.forename: A
authors.initials: A
authors.lastname: Vogt
authors.forename: M
authors.initials: M
authors.lastname: Schlitt
authors.forename: U
authors.initials: U
authors.lastname: Raaz
authors.forename: I
authors.initials: I
authors.lastname: Reindl
authors.forename: M
authors.initials: M
authors.lastname: Buerke
authors.forename: K
authors.initials: K
authors.lastname: Werdan
authors.forename: A
authors.initials: A
authors.lastname: Schlitt
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D015995:Prevalence; D018570:Risk Assessment; D017678:Sex Distribution; D015607:Stents / Q000706:statistics & numerical data*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome