Long-term clinical outcomes of drug-eluting stents vs. bare-metal stents in Chinese geriatric patients.
OBJECTIVE
Little is known about the relative efficacies of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and bare-metal stents (BMS) in elderly patients. The objective of this study was to evaluate the clinical outcome for geriatric patients who received either DES or BMS.


METHODS
From January 2002 to October 2005, 199 consecutive Chinese geriatric patients (≥ 75 years old) underwent PCI with coronary DES or BMS implantation at our institution. We analyzed the major clinical end points that included all-cause mortality, cardiovascular death, myocardial infarction, target lesion revascularization (TLR), stent thrombosis, and bleeding complications.


RESULTS
The three-year cumulative rates of all-cause mortality, cardiovascular death, and myocardial infarction were significantly lower in the DES group (6.3%, 3.6%, 5.4%) compared with the BMS group (16.2%, 11.5%, 14.9%; P < 0.05). No significant differences were found in the three-year cumulative rate for target lesion revascularization (6.3% vs. 4.6%, P = 0.61) or stent thrombosis (3.6% vs. 2.3%, P = 0.70). Likewise, there were no statistically significant differences in the cumulative rate for intracranial hemorrhage, or major and minor hemorrhage at three years.


CONCLUSIONS
DES-based PCI was associated with a significant reduction in the three-year cumulative rate of all-cause mortality, cardiovascular death, and myocardial infarction compared with BMS, without increased risk of TLR, stent thrombosis, or bleeding complications at three years in this group of Chinese geriatric patients.
Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Rd., Hong Kong, China.
Pak-Hei
PH
Chan
Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Rd., Hong Kong, China.
Sha-Sha
SS
Liu
Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Rd., Hong Kong, China.
Hung-Fat
HF
Tse
Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Rd., Aberdeen, Hong Kong, China.
Wing-Hing
WH
Chow
Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Rd., Aberdeen, Hong Kong, China.
Man-Hong
MH
Jim
Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Rd., Aberdeen, Hong Kong, China.
Hee-Hwa
HH
Ho
Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 102 Pokfulam Rd., Hong Kong, China.
Chung Wah
CW
Siu
Bare-metal stents; Drug-eluting stents; Geriatric patients; Percutaneous coronary intervention