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Percutaneous coronary angioplasty in elderly patients: Assessment of in-hospital outcomes
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Abstract
Background: We aimed to assess in-hospital outcomes of percutaneous transluminal coronary angioplasty (PTCA) in elderly subjects.
Methods: A total of 1000 consecutive patients, who had all been admitted for interventional treatment of symptomatic coronary artery disease, were retrospectively analysed.
Results: Elderly patients (≥ 70 years of age) were more likely to be diabetic, hypertensive and of female gender. They more frequently were diagnosed with chronic heart failure as well as prior stroke. Significantly higher proportions of the elderly population presented with cardiogenic shock and underwent PTCA as a result of acute coronary syndromes. Multivessel coronary disease affected a large majority of senior patients. Although stenting dominated in both age groups, balloon angioplasty was relatively more frequently applied in the elderly. Coronary angioplasty in elderly patients was associated with fewer direct stenting procedures, longer exposure to X-rays and a higher volume of the contrast medium. The efficacy of intervention, assessed according to clinical and angiographic criteria, was high in both groups, although revascularisation was significantly less complete while crude in-hospital mortality higher in the elderly group. Advanced age remained an independent predictor of both increased in-hospital mortality and longer exposure to X-rays after an adjustment for the baseline characteristics in multivariable analyses.
Conclusions: Despite frequent comorbidities and more extensive coronary athersoclerosis, a high rate of procedural success was achieved in the elderly population who underwent PTCA. However, after an adjustment for the baseline characteristics advanced age was still associated with a less favourable in-hospital outcome and a higher degree of procedural complexity. (Cardiol J 2007; 14: 143-154)
Abstract
Background: We aimed to assess in-hospital outcomes of percutaneous transluminal coronary angioplasty (PTCA) in elderly subjects.
Methods: A total of 1000 consecutive patients, who had all been admitted for interventional treatment of symptomatic coronary artery disease, were retrospectively analysed.
Results: Elderly patients (≥ 70 years of age) were more likely to be diabetic, hypertensive and of female gender. They more frequently were diagnosed with chronic heart failure as well as prior stroke. Significantly higher proportions of the elderly population presented with cardiogenic shock and underwent PTCA as a result of acute coronary syndromes. Multivessel coronary disease affected a large majority of senior patients. Although stenting dominated in both age groups, balloon angioplasty was relatively more frequently applied in the elderly. Coronary angioplasty in elderly patients was associated with fewer direct stenting procedures, longer exposure to X-rays and a higher volume of the contrast medium. The efficacy of intervention, assessed according to clinical and angiographic criteria, was high in both groups, although revascularisation was significantly less complete while crude in-hospital mortality higher in the elderly group. Advanced age remained an independent predictor of both increased in-hospital mortality and longer exposure to X-rays after an adjustment for the baseline characteristics in multivariable analyses.
Conclusions: Despite frequent comorbidities and more extensive coronary athersoclerosis, a high rate of procedural success was achieved in the elderly population who underwent PTCA. However, after an adjustment for the baseline characteristics advanced age was still associated with a less favourable in-hospital outcome and a higher degree of procedural complexity. (Cardiol J 2007; 14: 143-154)
Keywords
elderly patients; percutaneous transluminal coronary angioplasty; comorbidities; procedural characteristics; in-hospital mortality
About this articleTitle
Percutaneous coronary angioplasty in elderly patients: Assessment of in-hospital outcomes
Journal
Issue
Pages
143-154
Published online
2007-03-08
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678
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956
Bibliographic record
Cardiol J 2007;14(2):143-154.
Keywords
elderly patients
percutaneous transluminal coronary angioplasty
comorbidities
procedural characteristics
in-hospital mortality
Authors
Adam Sukiennik
Anna Król
Anna Jachalska
Marek Koziński
Tomasz Fabiszak
Aldona Kubica
Marek Radomski
Krzysztof Demidowicz
Maria Bogdan
Grzegorz Raczak
Tamara Sukiennik
Ewa Zabielska
Ryszard Dobosiewicz
Marcin Rychter
Mirosław Jabłoński
Tomasz Białoszyński
Maciej Chojnicki
Grzegorz Grzek
Jacek Kubica
