PERCUTANEOUS CORONARY ANGIOPLASTY IN PATIENTS OVER 75 YEARS OLD - IMMEDIATE AND MIDTERM RESULTS

Ninety-five patients 75 years or older (range 75-90, mean 79) underwen t PTCA from 1987 to 1991. Forty-two patients were 80 years or older. F orty-four had prior MI, 5% had prior coronary bypass surgery (CBS), 13 % had a prior history of recent cardiac failure, and 81% (7719.5) pres ented with unstable angina, refractory to intravenous treatment in 31 cases. The mean left ventricular ejection fraction was 62% (range 34%- 80%). Thirty-nine percent had single vessel disease, 41% had two vesse l disease, and 20% had three vessel disease. Coronary calcifications w ere present in 28%. A single vessel was dilated in 81 patients, two ve ssels in 14 patients; complete revascularization was achieved in 41%. The clinical angiographic primary success rate was 79% (75/95). There were five procedural deaths, five MI, five CBS and, ten hematomas. Fol low-up data were obtained in 100% cases, with a mean follow-up duratio n of 12 months (ranging from 1-36). There were four deaths, one MI, an d two CBS. Twenty percent (15/74) of patients had a second PTCA with a 73% success rate. Finally, 70% of the initial population was asymptom atic after first or second PTCA at mid-term follow-up. We conclude tha t PTCA is safe and effective in elderly patients, with 70% clinical su ccess rate at mid-term follow-up in spite of frequent incomplete revas cularization limited to the culprit lesion.