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Long-term clinical outcome of coronary artery stenting in elderly patients
Vassilis A Voudris1, John S Skoularigis, John S Malakos
1First Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece. vvoudris@otenet.gr
Insights
Coronary artery stenting is safe and effective for elderly patients with coronary artery disease, showing good long-term results. Age should not be a barrier to this treatment for older individuals.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Medicine
Background:
- Cardiovascular disease prevalence increases with age.
- Percutaneous coronary interventions in the elderly may carry higher risks.
- This study evaluates long-term outcomes of coronary stenting in elderly versus younger patients.
Purpose of the Study:
- To assess the long-term clinical outcomes of coronary artery stenting in elderly patients.
- To compare these outcomes with a cohort of younger patients.
- To determine if age is a limiting factor for coronary stenting.
Main Methods:
- Retrospective analysis of 402 patients undergoing coronary artery stenting.
- Group I: 69 elderly patients (>70 years).
- Group II: 333 younger patients (<=70 years).
- Standard percutaneous coronary intervention with stent implantation.
- Clinical outcomes and survival analyzed over a mean follow-up of 24 months.
Main Results:
- No significant difference in in-hospital complications or clinical success rates between groups.
- Complete revascularization was more frequent in younger patients (P < 0.05).
- Two-year event-free survival: 62% in elderly vs. 76% in younger patients (P < 0.001), primarily due to angina recurrence in the elderly.
- Impaired left ventricular systolic function (<40% ejection fraction) predicted late death.
Conclusions:
- Coronary artery stenting is an effective treatment for elderly patients with coronary artery disease.
- The procedure yields good short- and long-term results in this population.
- Age alone should not prevent elderly patients from receiving coronary stenting.
Background:
The elderly constitute a rapidly expanding segment of our population and cardiovascular disease becomes more prevalent with increasing age. Existing data have shown that percutaneous coronary interventions in the elderly are associated with an increase risk of in-hospital complications compared to younger patients. In the present study we retrospectively assessed the long-term clinical outcome of coronary artery stenting in an elderly population and compared them with the cohort of younger patients.
Methods:
The study population included 402 consecutive patients with coronary artery disease who underwent coronary artery stenting; of these 69 were elderly (age > 70 years, group I) and 333 were younger (age
Results:
No difference in in-hospital complications or clinical success rate was observed between the two groups of patients. Complete revascularization was obtained more frequently in younger compared to elderly patients (P < 0.05). At 2 years, event-free survival was 62% in the elderly and 76% in younger patients (P < 0.001); this difference was mostly made-up by recurrence of angina in the elderly. Impaired left ventricular systolic function (ejection fraction < 40%) was an independent predictor of late death.
Conclusions:
Coronary artery stenting is an effective therapeutic strategy in elderly with coronary artery disease and is associated with good short- and long-term results. Age per se should not preclude patients from undergoing coronary stenting.