PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IN THE ELDERLY

Background The world's population is growing older and, by the year 20 00, at least 580 million persons will have reached the age of 60 years or more. Coronary artery disease (CAD) is of particular concern in th is population since it is the most common cause of morbidity and morta lity in the elderly. Objective In the present review, we outline the r ole of percutaneous transluminal coronary angioplasty (PTCA) in the tr eatment of CAD in the elderly. Study selection We reviewed the informa tion in the leading medical literature on PTCA in the elderly, encompa ssing about 5000 cases and covering a period of 15 years. Data synthes is The success rates of: PTCA are not uniformly defined, but the repor ted data, especially those of recent years, are encouraging. In patien ts aged 65 or more, these rates are 75-97%, including procedures perfo rmed during acute myocardial infarction. Of the major complications re ported, death occurred in 0-10% and acute myocardial infarction in 0-7 .7% of the cases. Factors having a negative impact on the results were heart failure, prior myocardial infarction, obstructive lung disease and poor functional status before intervention. All of the reports sho wed favourable early and late outcomes of PTCA in the elderly. Conclus ions The data support the relative safety and clinical effectiveness o f PTCA in elderly patients and justify wider use of PTCA in selected p atients with multivessel disease in this age group. The data also sugg est that PTCA is an effective means of salvaging ischaemic myocardium during acute myocardial infarction in elderly patients.