LONG-TERM RESULTS AFTER SUCCESSFUL PERCUTANEOUS TRANSLUMINAL CORONARYANGIOPLASTY IN PATIENTS OVER 75 YEARS OF AGE

A prospective study comparing the long-term results of balloon angiopl asty in patients over 75 years of age with those in a younger patient group is not available. A total of 192 consecutive patients aged great er than or equal to 75 years (group I) who underwent a balloon angiopl asty were matched with 192 control patients aged 40 to 65 years (group II). The groups were matched for gender, angina pectoris class, left ventricular function, 1-, 2-, and S-vessel coronary artery disease, an d previous myocardial infarction. The mean follow-up was 40.4 months ( range 0 to 110). Actuarial analysis (freedom from events) after 5 year s yielded the following results for group I versus group II: free from death remained 77.1% versus 97.9% (p = 0.0001), from cardiac death 92 .4% versus 97.9% (p = 0.049), and from angina pectoris 54.6% versus 75 .1% (p = 0.03). The differences were not. significant for those remain ing free from myocardial infarction, repeat balloon angioplasty, or co ronary artery bypass grafting. When elderly patients with complete rev ascularization (n = 127) were compared with a matched control group of 127 patients aged 40 to 65 years who underwent complete revasculariza tion, there was only a significant difference in noncardiac death rate s. We conclude that patients > 75 years of age have a significant high er cardiac and noncardiac death rate and a higher incidence of angina pectoris after successful balloon angioplasty. However, the incidence of reintervention and myocardial infarction is lower in the elderly. I f complete revascularization is achieved in the elderly, then freedom from cardiac death and recurrence of angina pectoris would be comparab le to that in younger patients.