Characteristics of Coronary Artery Stenting in the Elderly over 70 Years Old: Short-Term Outcome and Long-Term Angiographic and Clinical Follow-Up

Chung, Wook Sung; Kim, Chong Jin; Seung, Ki Bae; Cho, Eun Joo; Moon, Keon Woong; Lee, Jong Min; Oh, Young Suk; Youn, Ho Joong; Chae, Jang Seong; Park, Ihn Soo; Kim, Jae Hyung; Choi, Kyu Bo; Hong, Soon Jo

Abstract

BACKGROUND AND OBJECTIVES
The elderly is the fast growing segment of the population in Korea. Elderly patients undergoing coronary revascularization are considered a high-risk group. Few data exist that relate the results of stenting in treating coronary artery disease in the elderly population. This study sought to compare the short- and long-term outcomes of elderly patients undergoing coronary artery stenting with those of younger patients.
METHODS
All elderly patients 70 years of age who underwent coronary artery stenting between January 1997 and July 1999 (n = 106) at our centers were compared to the patients <70 who underwent coronary artery stenting during the same time period (n = 597).
METHODS
Elderly patients presented with lower ejection fraction (52.9% vs. 57.4%, p = 0.001), more unstable angina (47% vs. 31%, p = 0.003), and more multivessel disease (67% vs. 51%, p = 0.005) than younger patients. Major in-hospital complications including death (0.9% vs. 0.5%, p = NS), procedural acute Q-wave myocardial infarction (0.9% vs. 0.3%, p = NS), and emergency CABG (0% vs. 0.3%, p = NS) did not differ between two groups. And also vascular complication rate was similar between two groups(1.9% vs. 1.0%, p = NS). Angiographic follow-up, obtained in both groups, demonstrated similar restenosis rates (26.5% vs. 24.9%, p = NS). Long-term clinical follow-up at 12 months showed major adverse cardiac events including death, acute myocardial infarction, and repeat revascularization were significantly higher in elderly patients than in younger patients (18.3% vs. 12.6%, p = 0.04).
CONCLUSIONS
Elderly patients with higher risk factors who underwent coronary artery stenting had similar rates of in-hospital procedural complications and similar rates of 6 months angiographic restenosis, compared to younger patients. Overall rates of major adverse cardiac events in the elderly population at 12 months postcoronary artery stenting were significantly higher than those of younger patients.