[Initial outcome of coronary intervention in elderly patients]

The effect of age on the early results of coronary intervention was examined retrospectively using the initial success rate of coronary angioplasty in 60 patients older than 70 years. Patients were selected from those who underwent coronary angioplasty at the Saiseikai Utsunomiya Hospital from January 1992 to December 1994. There were 267 patients with 350 lesions, 223 men and 44 women, aged from 31 to 79 years (mean age 61.4 +/- 9.8 years). The elderly group consisted of 60 patients (mean age 73.5 +/- 3.0 years) and the control group was 207 patients less than 70 years (mean age 57.9 +/- 8.2 years). Successful coronary dilatation was defined as > 20% reduction of stenosis with residual stenosis < 50%. Body mass index, presence of hypertension or diabetes mellitus and the ratio of smokers were not significantly different between the two groups. The elderly group included more women and patients with hyperlipidemia. Both groups had similar baseline extent of coronary artery disease, distribution of coronary artery stenosis type and left ventricular ejection fraction. The initial success rate for all patients was 93.4%. There was no significant difference in the initial success rate between the elderly and control groups (98.8% and 91.9%, respectively). There was no significant difference in major complication rate between the two groups (6.3% and 11.5%). Multivariate logistic regression analysis showed that only the type of coronary artery stenosis was significantly associated with initial success rate (p < 0.01). These results suggest that coronary intervention can be successfully performed with a low incidence of major complication in elderly patients.