PTCA in elderly patients: acute results and long-term follow-up

Acute results and long-term follow-up of percutaneous transluminal coronary angioplasty (PTCA) in 125 patients aged 75 to 90 years (79 men; 46 female; mean age 78 +/- 3 years), with mainly unstable angina (102 patients) are reported. Successful PTCA was achieved in 96 out of 108 patients (89%); occlusions could be reopened in eight out of 17 patients (47%). Thirty-eight procedures were multiple vessel or multiple lesion PTCA, so that the lesion-related success rate of PTCA was higher (91%). Major complications occurred in seven patients (5.6%) including one procedure-related death. In-hospital mortality was 3% and concerned exclusively patients with unstable angina and unsuccessful procedure. At a mean follow-up of 27 +/- 16 months (2 to 82 months) 13 additional patients had died: 10 from cardiovascular causes, three from cancer. In the meantime, three patients underwent non-fatal myocardial infarction and three elective bypass surgery; 26 patients had repeat PTCA. Eighty-seven of the 93 surviving patients with successful primary procedure and reintervention if necessary, were in anginal class I or II; only six were in class III. We conclude that the success rate of PTCA in elderly patients is comparable to that in younger patients, and that a successful procedure leads to continued relief of symptoms.