CORONARY ANGIOPLASTY IN OCTOGENARIANS - IMMEDIATE AND LONG-TERM RESULTS AND COMPARISON WITH A YOUNGER POPULATION

The safety and efficacy of percutaneous transluminal coronary angiopla sty (PTCA) was examined in a group of 91 octogenarians during 133 cons ecutive procedures and compared to the younger part of our PTCA popula tion (3,443 procedures) during an 8-year study period. Most octogenari ans presented with refractory or unstable angina pectoris and multives sel involvement, but had normal left ventricular function. The angiogr aphic success rate was 84%. Technical failure was observed in 12% of c ases and complications in 14%. Two early procedure related deaths were observed. Restenosis was estimated at 24%. The proportion surviving a nd the proportion without cardiac event estimated by the Kaplan-Meier method at 2 years were 0.89 and 0.60, respectively. In comparison to t he younger population, the immediate angiographic success was lower as a result of a higher incidence of technical failure (P < 0.05). Other wise, no difference in terms of restenosis or overall related complica tion rate was noted (P > 0.1). It is concluded that PTCA is an efficie nt and safe therapeutic option for octogenarians with severe or refrac tory angina pectoris. Technical failure is more frequently observed th an in younger patients and explains a lower immediate angiographic suc cess. Nevertheless, at 2-years follow-up, a large majority of patients are alive and asymptomatic.