title: Percutaneous Coronary Intervention Is More Beneficial Than Optimal Medical Therapy in Elderly Patients with Angina Pectoris.
abstract: OBJECTIVE
  Data comparing the clinical benefits of medical treatment with those of percutaneous coronary intervention (PCI) in an elderly population with angina pectoris are limited. Therefore, we evaluated the efficacy of elective PCI versus optimal medical treatment (OMT) in elderly patients (between 75 and 84 years old) with angina pectoris.
  
  
  METHODS
  One hundred seventy-seven patients with significant coronary artery stenosis were randomly assigned to either the PCI group (n=90) or the OMT group (n=87). The primary outcome was a composite of major adverse events in the 1-year follow-up period that included cardiovascular death, non-fatal myocardial infarction, coronary revascularization, and stroke.
  
  
  RESULTS
  Major adverse events occurred in 5 patients (5.6%) of the PCI group and in 17 patents (19.5%) of the OMT group (p=0.015). There were no significant differences between the PCI group and the OMT group in cardiac death [hazard ratio (HR) for the PCI group 0.454; 95% confidence interval (CI) 0.041-5.019, p=0.520], myocardial infarction (HR 0.399; 95% CI 0.039-4.050, p=0.437), or stroke (HR 0.919; 95% CI 0.057-14.709, p=0.952). However, the PCI group showed a significant preventive effect of the composite of major adverse events (HR 0.288; 95% CI 0.106-0.785, p=0.015) and against the need for coronary revascularization (HR 0.157; 95% CI 0.035-0.703, p=0.016).
  
  
  CONCLUSIONS
  Elective PCI reduced major adverse events and was found to be an effective treatment modality in elderly patients with angina pectoris and significant coronary artery stenosis, compared to OMT.
authors: Cardiovascular and Arrhythmia Center, College of Medicine, Chung-Ang University, Seoul, Korea.
authors: Hoyoun
authors: H
authors: Won
authors: Department of Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea.
authors: Ae Young
authors: AY
authors: Her
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Byeong Keuk
authors: BK
authors: Kim
authors: Department of Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea.
authors: Yong Hoon
authors: YH
authors: Kim
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Dong Ho
authors: DH
authors: Shin
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Jung Sun
authors: JS
authors: Kim
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Young Guk
authors: YG
authors: Ko
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Donghoon
authors: D
authors: Choi
authors: Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Hyuck Moon
authors: HM
authors: Kwon
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.|Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.|Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Yangsoo
authors: Y
authors: Jang
authors: Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.|Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.|Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea. mkhong61@yuhs.ac.
authors: Myeong Ki
authors: MK
authors: Hong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000401:mortality / Q000628:therapy*; D023921:Coronary Stenosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000517:prevention & control / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Percutaneous coronary intervention; angina pectoris; elderly patient