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

Abstract

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.

Acute myocardial infarction in elderly patients: comparative analysis of the predictors of mortality. The elderly versus the young

“…Direct coronary angioplasty performed in elderly patients (>75 years) was reported as a high-risk procedure due to the greater index of complications. The in-hospital mortality reported is greater in patients in this age group (0.8 to 8.5%) as compared with that in younger patients (0 to 1.8%) [11][12][13][14][16][17][18][19] . Hartzler et al 20 reported a 2.6 relative risk for mortality after direct coronary angioplasty in patients > 70 years, and, in this study, we found the same 2.6 relative risk using a cutoff for age of 65 years.…”

Coronary angioplasty in octogenarians. Quality of life and costs

“…While octogenarian patients have been followed for up to 7 years after coronary angioplasty [7][8][9][10] , little is known about the effect of PTCA on patients' symptoms and its relative costs as compared with younger patients. We report the results of a prospective study on quality of life and costs of PTCA among patients above 80 years and a younger control group.…”

Safety of Same Day Discharge Radial PCI in Patients Under and Over 75 Years of Age

“…Percutaneous coronary intervention (PCI) is increasingly used in elderly patients with coronary artery disease, as improved outcomes compared with medical treatment support the use of invasive procedures in these patients. [14][15][16][17][18] However, expansion of the indications for PCI, including the elderly patient, has resulted in increasing patient volumes in many catheter labs. Managing this large number of patients, often with no increasing resources, is a challenge for many centers.…”