Coronary angiography in elderly patients: Indications, results, consequences

Due to the continuous increase of elderly individuals in the society the ca rdiologist has to deal with elderly patients more often. The apparative exp enditures and the invasive procedure require a critical consideration of be nefits and risks prior to performing coronary angiography in these patients . The indication and frequency of coronary angiography in patients with eig hty years or above were investigated. Furthermore, the results of angiograp hy, the risks of the procedure and the therapeutic consequences were evalua ted. The whole study population consisted of 2500 consecutive patients (1557 men , 943 women), who underwent coronary angiography at our institution from Ja nuary 1(st) to November 16(th) in 1998. A retrospective analysis of 66 coro nary angiographies (3 %) in 61 patients (26 men, 35 women) aged 80 years or older was performed. Among these 61 patients, 51 were referred because of suspected coronary art ery disease. Due to the clinical presentation a high percentage (42 patient s = 82 %) was classified as having unstable angina. 10 patients were referr ed due to valvular heart disease. Single-vessel disease was found in 14, tw o-vessel disease in 5 and multi-vessel disease in 28 patients, respectively . Percutaneous coronary intervention was performed in 17 patients, among th ese were 9 patients with multi-vessel disease and PTCA of the culprit lesio n, and 3 patients underwent bypass surgery. Medical therapy was decided as to 28 patients. Aortic valve replacement was performed in 2 of 9 patients w ith aortic stenosis. The clinical appearance of coronary artery disease in elderly patients was mostly unstable angina, explaining the need for intervention. Coronary angi ography disclosed multivessel disease in 55 % of patients. A revascularizat ion procedure could be performed at least in 43 % of patients with multi-ve ssel disease.