1. Coronary stent implantation in patients older than 75 years of age: clinical profile and initial and long-term (3 years) outcome.
- Author
-
Muñoz JC, Alonso JJ, Duran JM, Gimeno F, Ramos B, Garcimartin I, de la Fuente L, Gomez I, and Fernandez-Aviles F
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Coronary Disease mortality, Coronary Restenosis therapy, Female, Follow-Up Studies, Heart Diseases mortality, Hospital Mortality, Humans, Male, Middle Aged, Multivariate Analysis, Prognosis, Stroke Volume, Treatment Outcome, Coronary Disease therapy, Stents adverse effects
- Abstract
Objective: The objective of this study was to compare the initial and long-term outcome of elderly and younger patients after coronary stent implantation., Methods: The evolutions of 76 patients aged >75 years and of 860 patients aged < or =75 years who underwent consecutive stenting (from June 1991 to June 1997) were compared in a cohort study., Results: The elderly patients had lower left ventricular ejection fractions (0.58 +/- 0.14 vs 0.61 +/- 0.13; P =.03) and more frequently had unstable angina (78.9% vs 55.3%; P <.0001), previous heart failure (10.5% vs 4.9%; P =.03), and multivessel disease (68.4% vs 58.3%; P =.08). After the procedure, the elderly patients showed a higher inhospital mortality rate (6.6% vs 2.4%; P =.03) and myocardial infarction rate (5.3% vs 1.7%; P =.04). The long-term follow-up period (mean, 3.2 +/- 1.4 years; median, 3.0 years) showed in the elderly a higher mortality rate (15.4% vs 5.8%; P =.006), a lower rate of repeat revascularization (9.2% vs 19.7%; P =.04), and a similar incidence rate of major adverse cardiac events (27.7% vs 28.2%; P =.93). Multivariate analysis of the elderly group identified female gender (hazard ratio, 2.19; 95% CI, 1.18 to 4.06; P =.012) and presence of multivessel disease (hazard ratio, 2.35; 95% CI, 1.05 to 5.26; P =.037) as independent predictors of further events., Conclusion: Patients aged >75 years have a less favorable baseline profile and higher inhospital and 3-year mortality rates. However, the incidence rate of major adverse cardiac events in the long term is acceptable and similar to that of younger patients.
- Published
- 2002
- Full Text
- View/download PDF