Long-term paclitaxel-eluting stent outcomes in elderly patients.

Area of Science:

• Cardiology
• Interventional Cardiology
• Geriatric Medicine

Background:

• Drug-eluting stents are standard for percutaneous coronary intervention.
• Limited data exists on drug-eluting stent outcomes in elderly populations.
• This study assesses paclitaxel-eluting stents (PES) in older patients.

Purpose of the Study:

• To evaluate the safety and efficacy of PES in elderly patients.
• To compare PES outcomes across different age groups.
• To compare PES with bare-metal stents in older individuals.

Main Methods:

• Pooled data from 5 randomized trials and 2 postmarket registries.
• Included nearly 10,000 patients, stratified by age (<60, 60-70, >70 years).
• Compared outcomes including death, myocardial infarction, stent thrombosis, and target lesion revascularization.

Main Results:

• Patients >70 years had more adverse baseline characteristics.
• In trials, older patients had higher mortality but comparable myocardial infarction, stent thrombosis, and target lesion revascularization rates.
• PES in patients >70 years showed lower target lesion revascularization versus bare-metal stents, with comparable safety outcomes.

Conclusions:

• Percutaneous coronary intervention with PES is safe and effective in elderly patients.
• Age alone should not be a reason to withhold PES treatment.
• Outcomes in patients >70 years were comparable to age-matched general population norms.