Drug coated balloon angioplasty in elderly patients with small vessel coronary disease.
BACKGROUND
Coronary angioplasty in advanced age is associated with higher rate of comorbidities and complications. Drug coated balloon only angioplasty (DCBA) has emerged as an alternative to treat small vessel coronary disease (SVCD), of reference vessel diameters <2.8 mm, with shorter duration of dual antiplatelet (DAPT). This is the first study to assess the DCBA efficacy in an elderly population with SVCD.


RESULTS
We performed a prospective study of 447 patients (334 patients aged <75 and 113 patients aged ⩾75 years old) acquired from the SeQuent Please Small Vessel 'Paclitaxel-Coated Balloon Only' registry. In the older age group, more patients have hypertension (89% versus 77%; p = 0.006), renal insufficiency (21% versus 6%; p < 0.001), atrial fibrillation (17% versus 7%; p = 0.001), and calcified lesions (33% versus 20%; p = 0.006). At 30 days, there was one myocardial infarction requiring target lesion revascularization (TLR) in the younger group. No major adverse cardiac event (MACE) was observed in the older group. At 9 months, the MACE rate in the younger group was 4.2% and 6.1% in the older group (p = 0.453), with TLR rates at 3.9% and 3.0% (p = 0.704) respectively. There was no cardiac death observed.


CONCLUSIONS
DBCA in the elderly with SVCD is as safe and effective compared with younger patients despite more complex anatomy and comorbidities.
Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore lukas_dasdo@yahoo.com.
Dasdo A
DA
Sinaga
Tan Tock Seng Hospital, Singapore.
Hee Hwa
HH
Ho
Department of Cardiology, Medical Clinic B, Ludwigshafen Clinics, Ludwigshafen, Germany.
Uwe
U
Zeymer
Medical Scientific Affairs, B. Braun Vascular Systems, Berlin, Germany.
Matthias
M
Waliszewski
Tan Tock Seng Hospital, Singapore.
Fahim H
FH
Jafary
Tan Tock Seng Hospital, Singapore.
Yau Wei
YW
Ooi
Tan Tock Seng Hospital, Singapore.
Jason K K
JK
Loh
Tan Tock Seng Hospital, Singapore.
Julian K B
JK
Tan
Tan Tock Seng Hospital, Singapore.
Paul J L
PJ
Ong
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D001208:Asia; D062906:Cardiac Catheters; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D020099:Coated Materials, Biocompatible; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D004867:Equipment Design; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D017239:Paclitaxel
clinical results; de novo lesion; drug coated balloon; older patients; small vessel disease