Early and long-term results of percutaneous transluminal coronary angioplasty in patients 70 years of age and older with angina pectoris

Simpfendorfer, Conrad; Raymond, Russell; Schraider, James; Badhwar, Kavita; Dorosti, Khosrow; Franco, Irving; Hollman, Jay; Whitlow, Patrick L.

doi:10.1016/0002-9149(88)90901-0

Cited by 48 publications

(6 citation statements)

References 7 publications

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“…However, 79% of the patients only had single vessel disease, and comorbidity was also excluded. Similarly, Simpfendorfer, et al 19 reported excellent PTCA outcomes in patients aged in their 70's, but he selected for patients with excellent heart function and with a predominance of single vessel disease.…”

Section: Discussionmentioning

confidence: 99%

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PTCA in the Elderly: The “Young‐Old” versus the “Old‐Old”

Forman¹,

Berman²,

McCabe³

et al. 1992

J American Geriatrics Society

171

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Section: Discussionmentioning

confidence: 99%

“…This conclusion is especially significant since we included all patients undergoing de novo PTCA regardless of their clinical situation. Studies like those of Simpfendorfer, 19 Raizner, 20 and Rich 23 have better outcomes when comorbidities and multivessel disease are excluded. Age of the patient does not seem to be the critical issue.…”

Section: Discussionmentioning

confidence: 99%

PTCA in the Elderly: The “Young‐Old” versus the “Old‐Old”

Forman¹,

Berman²,

McCabe³

et al. 1992

J American Geriatrics Society

171

View full text Add to dashboard Cite

show abstract

“…Age itself is a very powerful determinant for the clinical outcome in ACS patients after PCI [16,17,41,42]. Periprocedural mortality risk after PCI demonstrates a curvilinear relationship with age.…”

Section: Outcomementioning

confidence: 99%

Impact of age on outcomes of percutaneous coronary intervention in acute coronary syndromes patients

Bauer¹,

Zeymer²

2010

Interventional Cardiology

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Impact of age on outcomes of percutaneous coronary intervention in acute coronary syndromes patients REVIEW Percutaneous coronary intervention (PCI) is a safe and effective procedure to reconstitute myocardial perfusion and has been demonstrated to improve prognosis in patients with acute coronary syndrome. With advancing age, PCI carries a higher risk for acute coronary and other vascular complications. Periprocedural mortality risk after PCI demonstrates a curvilinear relationship with age, with the highest mortality rates in the elderly. However, the magnitude of risk depends strongly on the presence and severity of additional clinical, angiographic and procedural factors. Among patients with acute coronary syndrome, the most meaningful mortality predictors are hemodynamic instability and acute ST elevation myocardial infarction. In addition, comorbidities such as renal insufficiency, diffuse and calcified coronary pathology and procedural complications increase the risk for death. Therefore, decision-making in interventional procedures is not solely dependent on the numerical age but mainly on additional factors. However, despite a higher rate of complications, PCI has been shown to improve clinical outcomes in the elderly with acute coronary syndrome.KEYWORDS: acute coronary syndrome n age n mortality n percutaneous coronary intervention n prognosis Executive summary Coronary artery diseaseLuminal enlargement, calcification, intimal and medial thickening and vascular stiffness increase, and endothelial function declines with age. Coronary angiography reveals more severe coronary artery disease with advancing age. Cardiac & noncardiac comorbiditiesBaseline risk profile increases with age: there is more diabetes, hypertension, renal insufficiency, history of atherothrombotic events or percutaneous coronary intervention (PCI)/coronary artery bypass graft, congestive heart failure and cardiogenic shock. Non-ST elevation acute coronary syndromesAs the mean age is higher than in ST elevation myocardial infarction (STEMI), the elderly comprise an increasing proportion of patients with non-ST elevation acute coronary syndromes (ACS). The elderly possibly show a greater benefit for an early invasive strategy than younger patients. The elderly receive invasive treatment less frequently. ST elevation myocardial infarctionPatients with STEMI are younger than patients with non-ST elevation ACS. With advancing age, patients present more frequently with atypical symptoms and less often receive primary PCI. Although primary PCI improves outcomes over fibrinolysis, it does not appear to be more beneficial in older patients than in younger patients, but does reduce the rate of stroke substantially in the elderly. Procedural detailsHigh-risk interventions become more prevalent with increasing age. Procedural success rates are very high in all age groups, with no major age-related differences. Coronary stenting rates are not different between younger and elderly patients. The elderly receive drug-eluting stents less often in co...

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“…Nevertheless, compared with prior registry data, these are the lowest event rates ever documented in clinical practice. In the era predating stenting procedural mortality was almost 20% [14,15]. At the end of the 1990s, Munoz observed an in-hospital mortality of 2.3%, and Assali 6.6% after elective interventions in a period when the use of stents was still rather low [5,16].…”

Section: Discussionmentioning

confidence: 99%