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

Abstract

Background and Objectives:The average population in Korea is gradually becoming older. Elderly patients undergoing coronary revascularization are considered to be a high-risk group. There is a paucity of data that relates the results of stenting in treating coronary artery disease in the elderly population. This study compared the shortand long-term outcomes of elderly patients undergoing coronary artery stenting with those of younger patients. Materials and Method:The elddrly patients ≥70 years of age who underwent coronary artery stenting between January 1997 and July 1999 (n=106) at our centers were compared with patients <70 years of age who also underwent coronary artery stenting during the same time period (n=597). Results:Elderly patients presented with a lower ejection fraction (52.9% vs. 57.4%, p=0.001), more unstable angina (47% vs. 31%, p=0.003), and a greater incidence of multivessel disease (67% vs. 51%, p=0.005) than the younger patients. There were no differences in 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) between two groups. Furthermore, the vascular complication rate was similar between the two groups (1.9% vs. 1.0%, p=NS). An 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 that 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). Conclusion:Elderly patients with higher risk factors who underwent coronary artery stenting had similar rates of in-hospital procedural complications and similar rates of angiographic restenosis after 6 months follow-up, compared to younger patients. The 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. (Korean Circulation J 2001; 31(10):996-1003)