Percutaneous Transluminal Coronary Angioplasty in the Elderly Patients: Initial Success Rate and Angiographic Follow-up

Park, Seong Wook; Park, Seung Jung; Kim, Jae Joong; Song, Jae Kwan; Kim, Hyung Ho; Doo, Young Cheoul; Lee, Jong Koo

Abstract

BACKGROUND
Although coronary bypass grafting has been shown to prolong life and to relieve symptoms in the early patients with symptomatic coronary artery disease, the operative mortality and morbidity are higher than in younger patients. For this reason percutaneous transluminal coronary angioplasty(PTCA) is a potentially attractive and less invasive alternative to bypass surgery in elderly patients. This study was done to evaluate the feasibility and the initial success rate of PTCA in patients over 70 years of age compared to younger patients group. METHODS: Patients were selected and grouped as I (age 50~69) and II (age over 70) from the consecutive patients who underwent coronary angioplasty at Asan Medical Center from July 1989 to October 1991. Coronary angioplasty was performed at 121 lesions in group I (92 patients) and at 44 lesions in group II (24 patients). RESULTS: Clinically unstable angina and angiographically multivessel disease were more frequent in the elderly patients than in younger patients.The overall initial success rate of PTCA for the elderly and younger patients group were 95.5% and 82.6% respectively. The rate of major complications of PTCA in the elderly patients was not different from that of younger patients:Acute myocardial infarction in 1, energency coronary bypass operation in 1 and cardiac tamponade in 1 patients. There was no difference in the rate of angiographic restenosis between elderly (27.8%) and younger patients group (35.7%). CONCLUSION: PTCA may be appropriate therapeutic modality in the selected group of elderly patients, with high initial success and low cpmplication rate, and follow-up study would be necessary to evaluate the rate of long-term survival and event-free survival after PTCA.