Abstract
Background: Octogenarians have been under-represented in percutaneous coronary intervention (PCI) trials, thus making difficult to choose the best type of stent in this patient population. We compared the outcomes of drug eluting (DES) and bare metal stent (BMS) at one year after implantation in this special population. Methods: A total of 320 patients over 80 years undergoing PCI with BMS (n=218) or DES (n=102) between January 2000 and March 2008 were retrospectively studied. In-hospital and one year major adverse cardiac events (MACE) defined as cardiac related death, non-fatal myocardial infarction, target vessel (TVR) and target lesion revascularization (TLR) were compared between the two groups. Cox regression analysis was used for data analysis. Results: The cumulative incidence of in-hospital MACE between the BMS and DES group were similar (3.6% vs 2.9%; P=0.32). The one year incidence of MACE event was higher in the BMS group (18.8% vs 9.8%, adjusted relative risk [RR] 2.33; 95% confidence interval [C.I.]: 1.12 to 4.86; P=0.02) Figure-1. Diabetes mellitus was an independent predictor for increased MACE event (adjusted RR: 1.99; C.I: 1.06 to 3.77, P= 0.03). One year cumulative incidence of TLR and TVR was higher in the BMS group (10.0% vs 3.9% adjusted RR : 2.94 ; C.I. 1.01 to 8.59 P=0.05) Figure 2. Conclusion: During one year follow up, octogenarians treated with BMS had an increased risk of MACE compared with those treated with DES. DES should be preferred in indications recognized from current PCI guidelines.
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