title: Long term outcomes in octogenarians undergoing percutaneous coronary intervention: comparison of bare metal versus drug eluting stent.
abstract: BACKGROUND
  Octogenarians have been under-represented in percutaneous coronary intervention (PCI) trials, thus making difficult to choose the best type of stent in this patient population. We compared the outcomes of drug eluting (DES) and bare metal stent (BMS) at one year after implantation in this special population.
  
  
  METHODS
  A total of 320 consecutive patients over 80 years undergoing PCI with BMS (n=218) or DES (n=102) were retrospectively studied. One year major adverse cardiac events (MACEs) defined as cardiac death, non-fatal myocardial infarction and target vessel revascularization (TVR) were compared between the two groups. Cox regression analysis was used for data analysis.
  
  
  RESULTS
  The one year incidence of MACE was higher in the BMS group (18.8% vs 9.8%, adjusted hazard ratio [HR] 2.33; 95% confidence interval [C.I.]: 1.12 to 4.86 p=0.02). Diabetes mellitus was an independent predictor for increased MACE (adjusted HR: 1.99; C.I. 1.06 to 3.77, p=0.03). One year incidence of TVR was higher in the BMS group (10.0% vs 3.9% adjusted HR: 2.94; C.I. 1.01 to 8.59 p=0.045). There was no difference in cardiac death between the two groups.
  
  
  CONCLUSIONS
  During one year follow-up, octogenarians treated with BMS had an increased risk of MACE compared with those treated with DES. DES should be preferred in indications recognized from current PCI guidelines.
authors.affiliation: Division of Cardiology, Baystate Medical Center, Springfield, MA, United States. Electronic address: shanmugam.uthamalingam@baystatehealth.org.
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Uthamalingam
authors.affiliation: Division of Cardiology, Michigan State University, East Lansing, MI, United States.
authors.forename: Imad
authors.initials: I
authors.lastname: Ahmado
authors.affiliation: Department of Internal Medicine, Baystate Medical Center, Springfield, MA, United States.
authors.forename: Vijairam
authors.initials: V
authors.lastname: Selvaraj
authors.affiliation: New England Heart Institute, Catholic Medical Center, Manchester, NH, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Dewey
authors.affiliation: New England Heart Institute, Catholic Medical Center, Manchester, NH, United States.
authors.forename: James
authors.initials: J
authors.lastname: Flynn
mesh_terms: D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation / Q000639:trends*; D012189:Retrospective Studies; D015607:Stents / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Coronary syndrome; Elderly; Octogenarians; Stent