Details

Autor(en) / Beteiligte

• Ma, Han-ying
• Zhou, Yu-jie
• Dick, Ronald J
• Shi, Dong-mei
• Liu, Yu-yang
• Cheng, Wan-jun
• Guo, Yong-he
• Wang, Jian-long
• Ge, Hai-long

Titel

Long-term outcome of patients of over 85 years old with acute coronary syndrome undergoing percutaneous coronary stenting： a comparison of bare metal stent and drug eluting stent

Ist Teil von

• Chinese medical journal, 2008-05, Vol.121 (10), p.887-891

Ort / Verlag

China: 12th Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China%Department of Cardiology, Epworth Hospital, Melbourne,Australia

Erscheinungsjahr

2008

Quelle

Elektronische Zeitschriftenbibliothek - Freely accessible e-journals

Beschreibungen/Notizen

• Background Patients aged over 85 years have been under-represented in percutaneous coronary intervention （PCI） trials despite an increase in referrals for PCI. The long-term safety and efficacy of percutaneous coronary stenting in patients aged over 85 years with acute coronary syndrome （ACS） remain unclear. Moreover it is unknown whether there are differences between bare metal stent （BMS） and drug eluting stent iDES） in this special population. Methods A total of 80 patients with ACS aged over 85 years undergoing stenting （BMS group n=21 vs DES group n=59） were retrospectively studied. In-hospital, one year and overall clinical follow-up （12-36 months） of major adverse cardiac events （MACEs） including cardiac deaths, myocardial infarction, target lesion revascutarization （TLR） and target vessel revascularization （TVR） as well as stroke and other major bleeding were compared between the two groups. Results In the entire cohort, the procedure success rate was 93.8% with TIMI-3 coronary flow post-PCI in 93.8% of the vessels and the procedure related complication was 17.5%. The incidence of in-hospital MACEs in BMS group was higher （14.3% vs 6.8%, P=0.30）. The 1-year incidence of MACEs in DES group was 7.0% while there was no MACE in the BMS group. Clinical follow-up for 12-36 months showed that the overall survival free from MACE was 82.9% and the incidence of MACE in the BMS group was lower （5.3% vs 21.1%, P=0.20）. Multivariate regression analysis showed that the creatinine level （OR：. 1.013; 95%CI： 1.006-1.020; P=0.004） and hypertension （OR; 3.201; 95%CI： 1.000-10.663; P=0.04） are two major factors affecting the long-term MACE. Conclusions Percutaneous coronary stenting in patients aged over 85 years is safe and provides good short and tona-term efficacy. Patients with renal dvsfunction and hvoertension may have a relatively hiah incidence of MACE.