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Percutaneous coronary intervention in the elderly: procedural success and 1-year outcomes
Authors:Eckart Robert E  Shry Eric A  Simpson Daniel E  Stajduhar Karl C
Institution:From the Brooke Army Medical Center, San Antonio, TX;;University of Texas Health Sciences Center at San Antonio, TX;;and Walter Reed Army Medical Center, Washington, DC
Abstract:Clinical trials have found increased morbidity in elderly persons presenting for percutaneous coronary intervention for chronic stable angina. Long-term follow-up is limited for the elderly following percutaneous coronary intervention. The authors reviewed all coronary interventions performed from January 1998 to August 2001. One year following the procedure, subjects were screened for death, need for revascularization, and myocardial infarction. There were 401 subjects aged ≥65years (mean 73.4±6.0years) and 479 subjects aged <65years (mean 55.6±6.7 years). Although there was no difference in 1-year rate of subsequent myocardial infarction or in revascularization, the elderly were more likely to die during hospitalization (4.7% vs. 1.0%, p<0.01), and at 1 year (10.2% vs. 4.0%, p<0.01). When controlled for ejection fraction, age was no longer significant in either predischarge mortality or in 1-year mortality. Excess postpercutaneous coronary intervention mortality in the elderly may be due to underlying comorbidities and not due to subsequent myocardial infarction or revascularization.
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