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[Coronary stent implantation in elderly patients: acute and long-term results]

B Assmus1, D H Walter, M B Britten

  • 1Medizinische Klinik IV, Abteilung für Kardiologie/Nephrologie, J.W.-Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.

Zeitschrift Fur Kardiologie
|September 5, 2003
PubMed

Insights

Coronary stent implantation is safe for elderly patients with coronary heart disease, showing comparable procedural success and restenosis rates. Advanced age alone should not preclude this treatment in selected individuals.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • The prevalence of coronary heart disease is increasing in the elderly population.
  • Elderly patients often present with more complex baseline characteristics, potentially increasing risks associated with percutaneous transluminal coronary angioplasty (PTCA).
  • The benefit of routine coronary stent use in older adults remains unclear.

Purpose of the Study:

  • To evaluate the impact of age on acute procedural success, restenosis rates, and major adverse cardiovascular events following intra-coronary stent implantation.
  • To determine if advanced age is an independent predictor of adverse outcomes after coronary stenting.

Main Methods:

  • A study involving 1306 patients undergoing intra-coronary stent implantation.
  • Patients were categorized into three age groups: <65 years, 65-75 years, and >75 years.
  • Outcomes assessed included acute procedural success, quantitative coronary angiography for restenosis, and major cardiovascular events (death/myocardial infarction) at 6 months.

Main Results:

  • Older patients exhibited higher rates of multivessel disease and lower left ventricular ejection fraction.
  • Acute success and restenosis rates were similar across all age groups.
  • Older patients experienced significantly more adverse clinical events, but multivariate analysis identified impaired left ventricular function, not age, as the independent predictor.

Conclusions:

  • Coronary stent implantation can be considered in selected elderly patients after careful clinical assessment.
  • Advanced age should not be an absolute contraindication for coronary stent implantation.
Abstract

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