Korean Circ J.  2007 Dec;37(12):647-655. 10.4070/kcj.2007.37.12.647.

Long-Term Clinical Outcomes of Percutaneous Coronary Intervention Using Drug-Eluting Stents in Octogenarians and Older

• Lee SH
• Chae JK

• KMID: 2227041
• DOI: http://doi.org/10.4070/kcj.2007.37.12.647

Abstract

BACKGROUND AND OBJECTIVES: In this current era of using drug-eluting stents (DES), studies that demonstrate the feasibility and clinical outcome of percutaneous coronary intervention (PCI) using DES in a subset of extremely aged patients are lacking. We investigated the clinical characteristics, therapeutic and clinical outcomes of patients older than 80 years that had been implanted with DES during a PCI.
SUBJECTS AND METHODS
Fifty-three "octogenarian" patients (> or =80-years-old) and 1036 "non-octogenarian" patients (<80-years-old) that had been implanted with DES at Chonbuk National University Hospital since March 2003 were enrolled in the study. Medical records of the patients in the two groups were retrospectively reviewed.
RESULTS
The mean ages of the patients in the two groups were 83+/-2 years and 62+/-11 years, respectively, and the mean follow-up period was 15.8+/-10.9 months and 21.1+/-10.8 months, respectively. The octogenarian group showed an increased prevalence of female patients (58.5% vs. 35.1%, p=0.001), acute coronary syndrome (98.1% vs. 78.6%, p=0.001), ST-segment elevation myocardial infarction (41.5% vs. 28.3%, p=0.003), shock (17.0% vs. 6.6%, p=0.004), heart failure (22.6% vs. 9.3%, p=0.002) and a higher in-hospital major adverse cardiac event (MACE) rate (13.2% vs. 3.5%, p=0.004) than the non-octogenarian patients. Angiographic restenosis and target lesion revascularization rates were not different in both groups, but overall MACE (18.9% vs. 9.9%, p=0.035) and all-cause mortality (p<0.001) rates were significantly higher in the octogenarian group of patients.
CONCLUSION
Although angiographic follow-up results were comparable in octogenarians and non-octogenarians, the occurrence of short- and long-term MACE was significantly higher in the very elderly group owing to a substantial subset of high-risk patients.

Keyword

Aged, 80 and over; Coronary disease; Stents

MeSH Terms

Acute Coronary Syndrome
Aged
Aged, 80 and over*
Coronary Disease
Drug-Eluting Stents*
Female
Follow-Up Studies
Heart Failure
Humans
Jeollabuk-do
Medical Records
Mortality
Myocardial Infarction
Percutaneous Coronary Intervention*
Prevalence
Retrospective Studies
Shock
Stents

Figure

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  Fig. 1 Kaplan-Meier curve showing mortality-free survival.

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