Coronary artery stenting in the aged

OBJECTIVES The study compared the safety and efficacy of coronary artery st enting in aged and nonaged patients and identified predictors of adverse cl inical outcomes. BACKGROUND Limited. data are available on the outcomes of stenting in the a ged (greater than or equal to 80 years) compared to nonaged patients. METHODS The study was a pooled analysis of 6,186 patients who underwent cor onary artery stenting in six recent multicenter trials. A clinical events c ommittee adjudicated clinical end points, and quantitative angiography was performed by an independent core laboratory. RESULTS There were 301 (4.9%) aged patients (greater than or equal to 80 ye ars). Compared to nonaged patients, aged patients had a higher prevalence o f multivessel disease (16.5% vs. 9.6%, p = 0.001), unstable ang ina (50.8% vs. 42.1%, p = 0.003), moderate to severe target lesion calcification (30.4 % vs. 15.3%, p = 0.001) and smaller reference vessel diameter (2.90 mm vs. 2.98 mm, p = 0.004). Procedural success rate (97.4%, vs. 98.5%, p = 0.14) w as similar in the two groups. In-hospital mortality (1.33% vs. 0.10%, p = 0 .001), bleeding complications (4.98% vs. 1.00%, p < 0.001) and one-year mor tality (5.65% vs. 1.41%, p < 0.001) were significantly higher for the aged patients. Clinical restenosis was similar for the two groups (11.19% vs. 11 .93%, p = 0.78). Advanced age, diabetes, prior myocardial infarction and pr esence of three-vessel disease were independent predictors of long-term mor tality. CONCLUSIONS Coronary artery stenting can be performed safely in patients gr eater than or equal to 80 years of age, with excellent acute results and a low rate of clinical restenosis, albeit with higher incidences of in-hospit al and long-term mortality, and vascular and bleeding complications compare d to nonaged patients. ii Am Coil Cardiol 2001;37:856-62) (C) 2001 by the A merican College of Cardiology.