title: The influence of age on clinical outcomes in patients treated with the resolute zotarolimus-eluting stent.
abstract: OBJECTIVE
  To evaluate the rate of clinical events and bleeding risk according to age in patients undergoing percutaneous coronary intervention (PCI) with a new-generation drug-eluting stent (DES) enrolled in the RESOLUTE Global Clinical Program.
  
  
  METHODS
  This study represents a pooled analysis of five trials included in the RESOLUTE program including 5,130 patients, of whom 1,675 (32.6%) were ≥70 years old (elderly patients).
  
  
  RESULTS
  After adjusting for confounders, age ≥70 years was a significant predictor of high mortality at 30 days (0.6 vs. 0.1%, P = 0.017) and 2 years (7.2 vs. 2%, P < 0.001). No differences were seen with respect to acute myocardial infarction (MI) or target lesion and vessel revascularization rates between young and elderly patients. Bleeding rates were higher in the elderly throughout follow-up. In the elderly, 7 of the 27 (26%) patients with bleeding episodes died, with a median time between bleeding episode to death of 21 days. In the younger population, 1 patient of 17 with a bleeding episode died (400 days later).
  
  
  CONCLUSIONS
  Elderly patients undergoing PCI with a new-generation DES have increased mortality and bleeding risk, with similar rates of acute MI and repeat revascularization. Bleeding risk was higher in the elderly and strongly related to death. Target lesion failure rates were not significantly different between the two age groups, suggesting that the Resolute zotarolimus-eluting stent (R-ZES) is effective for patients younger and older than 70 years of age. R-ZES may be recommended for elderly patients when PCI with a DES is identified as a suitable option.
authors: Department of Cardiology, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina.
authors: Jorge
authors: J
authors: Belardi
authors: Cardiology Department, Royal Victoria Hospital, Belfast, Northern Ireland, United Kingdom.
authors: Ganesh
authors: G
authors: Manoharan
authors: Department of Cardiac Surgery and Department of Images, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina.
authors: Mariano
authors: M
authors: Albertal
authors: Cardiology Department, the Third Faculty of Medicine, Charles University & University Hospital Royal Vineyards, Prague, Czech Republic.
authors: Petr
authors: P
authors: Widimský
authors: Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany.
authors: Franz-Joseph
authors: FJ
authors: Neumann
authors: Department of Cardiology, Heart Centre at the Isar, Munich, Germany.
authors: Sigmund
authors: S
authors: Silber
authors: Department of Medicine, Division of Cardiology, Columbia University Medical Center and NewYork-Presbyterian Hospital, New York, New York.
authors: Martin B
authors: MB
authors: Leon
authors: Department of Cardiology & Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura City, Japan.
authors: Shigeru
authors: S
authors: Saito
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D064887:Observational Studies as Topic; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; C489443:zotarolimus; D020123:Sirolimus
keywords: aged; drug-eluting stents; hemorrhage; myocardial infarction; percutaneous coronary intervention