[Coronary angioplasty in the aged]

Area of Science:

• Cardiology
• Geriatric Medicine

Background:

• The safety and efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) in elderly patients remain under-established.
• Ischemic heart disease poses significant risks for older adults, necessitating effective treatment options.

Purpose of the Study:

• To evaluate the safety and clinical efficacy of PTCA in patients aged 65 and older.
• To assess complication rates, recurrence rates, and long-term outcomes following PTCA in a geriatric population.

Main Methods:

• PTCA was performed on 34 patients aged 65 or more with symptomatic ischemic heart disease.
• Outcomes including procedural success, complications, clinical recurrence, and angiographic restenosis were monitored.
• Follow-up included clinical assessment and coronary angiography at a mean of 6.3 months post-procedure.

Main Results:

• Primary success was achieved in 85.3% of patients.
• Significant complications occurred in 8.8%, including two emergency surgeries (5.8%) and one myocardial infarction (3%).
• At a mean follow-up of 13.8 months, 73.4% of patients were asymptomatic, with a 26.6% clinical recurrence rate and 52.6% angiographic restenosis rate.

Conclusions:

• PTCA is a viable therapeutic option for selected elderly patients with ischemic heart disease.
• The procedure demonstrates a good success rate, acceptable complications, and a relatively low clinical recurrence rate in this population.
• Further consideration of PTCA for geriatric patients is warranted, with restenosis being manageable through repeat procedures.