Is coronary angioplasty safe in the elderly?
H K Beydoun1, B J O'Neill, R J Teskey
1Queen Elizabeth II Health Sciences Centre, Halifax, Canada. hbeydoun@is.dal.ca
The Canadian Journal of Cardiology
|May 1, 2001
Summary
Percutaneous transluminal coronary angioplasty (PTCA) is safe and effective in elderly patients, including those 80 and older. This study shows high procedural success rates and acceptable risks, suggesting age alone shouldn't limit PTCA use.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Medicine
Background:
- Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for coronary artery disease.
- The safety and efficacy of PTCA in elderly populations require specific evaluation due to potential comorbidities and physiological changes.
Purpose of the Study:
- To assess the utilization and immediate procedural outcomes of PTCA in elderly patients (≥60 years) at a tertiary care center.
- To compare outcomes across different age subgroups within the elderly population.
Main Methods:
- A retrospective cohort study of 2322 patients aged 60 years or older who underwent PTCA between January 1992 and December 1997.
- Patients were stratified into three groups: 60-69 years (Group A), 70-79 years (Group B), and 80+ years (Group C).
- Outcomes including procedural success, complications, and need for emergency coronary artery bypass graft (CABG) were analyzed.
Main Results:
- Procedural success rates were high and similar across all age groups (93% in Group A, 92.7% in Group B, 91.7% in Group C).
- Patients in the oldest group (80+) had a higher incidence of severe angina (Class IV) and pre-procedural myocardial infarction.
- The rate of emergency CABG was lower in the oldest group (0.75%) compared to younger elderly groups (3.4%).
Conclusions:
- Percutaneous transluminal coronary angioplasty can be performed in very elderly patients with high procedural success and acceptable risk.
- Age alone should not be a limiting factor when considering PTCA for elderly patients.
- The findings support the expanded use of PTCA in geriatric populations with coronary artery disease.
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