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[Coronary angioplasty in patients over 70. An analysis of 115 dilatations]
E de M Ayres Neto1, J L dos Santos, C Greguolo
1Instituto do Coração, Santa Casa de RP, SP.
Insights
Percutaneous transluminal coronary angioplasty (PTCA) is effective for elderly patients over 70. This study shows acceptable success rates and low complication risks in this demographic.
Area of Science:
- Cardiology
- Interventional Cardiology
- Geriatric Medicine
Background:
- Transluminal coronary angioplasty (PTCA) is a common procedure for coronary artery disease.
- The efficacy and safety of PTCA in elderly populations (over 70 years) require specific evaluation.
Purpose of the Study:
- To assess the validity and outcomes of PTCA in patients aged 70 and above.
- To determine the success rates and complication profile of PTCA in elderly individuals.
Main Methods:
- Retrospective analysis of 115 PTCA procedures in 89 patients aged 70-85.
- Patients categorized into single (n=77), double (n=9), and triple (n=3) vessel disease groups.
- Outcomes evaluated based on successful dilation, complication rates, and need for emergency bypass grafting.
Main Results:
- Successful dilation rates varied by disease severity: 81.8% (single), 72.2% (double), and 75% (triple vessel).
- Overall success rate improved with experience, rising from 60.6% to 82.5% after the initial 250 angioplasties.
- Major complications included a 4.4% mortality rate, 1.08% ventricular fibrillation, and 6.6% acute coronary occlusion. Emergency coronary artery bypass grafting was needed in 4.4% of cases.
Conclusions:
- PTCA is a viable and effective treatment option for elderly patients with coronary artery disease.
- The procedure demonstrates acceptable success rates and a manageable complication profile in this age group.
Purpose:
To verify the validity of transluminal coronary angioplasty (PTCA) in the population over 70 years old.
Methods:
Retrospectively, were analysed 115 PTCA performed in 89 elderly patients (70 to 85 years old) from January 1988 to January 1991. Three groups were defined: A) single vessel-77 (86.5%) patients; B) double vessel-9 (10.1%) patients; C) three vessel-3 (3.4%) patients.
Results:
Of the 89 treated patients, 81.8% in group A, 72.2% in group B and 75% in group C were successfully dilated. The learning curve had showed increase in success rate after the first 250 angioplasties (from 60.6% to 82.5%). Treatment of acute myocardial infarction by direct thrombolysis was made in 7 patients (6 S, 1 I). Major complications included: deaths (4.4%), ventricular fibrillation (1.08%), acute coronary occlusion (6.6%). Emergency coronary artery bypass grafting was required in 4.4% with one death.
Conclusion:
Coronary angioplasty is an effective treatment in elderly patients and may be performed with acceptable success and with low complications.