- 作者：Ramó ; n Ló ; pez-Palop ; Pilar Carrillo ; Araceli Frutos ; Alberto Cordero ; Daniel Nú ; ñ ; ez ; Marlon Toro ; Vicente Bertomeu-Martí ; nez
- 关键词：Stent ; Geriatrics ; Prognosis ; Revascularization
- 刊名：Revista Española de Cardiología (English Edition)
- 出版年：2009
- 出版时间：November 2009
- 年：2009
- 卷：62
- 期：11
- 页码：1250-1259
- 全文大小：222 K
Introduction and objectives
The effectiveness of coronary drug-eluting stents has not been fully studied in very elderly patients who have clinical features that predispose them to side effects and long-term adverse events.Methods
The safety and efficacy of drug-eluting stents were studied in a historical cohort of consecutive octogenarian patients who underwent percutaneous coronary intervention.
Results
Between 2002 and 2006, 176 octogenarian patients were treated using coronary stents: ninety with drug-eluting stents and 86 with bare-metal stents only. Patients treated using drug-eluting stents had a greater number of diseased vessels (2.28 [0.85] vs 1.87 [0.87]; P=.002), had more vessels treated (1.74 [0.79] vs 1.17 [0.47]; P<.0005), were more likely to have multivessel disease (79 % vs 59 % ; P=.005) and to undergo left main coronary artery treatment (20 % vs 1.0 % ; P<.0005), and had longer (26.6 [6.7] mm vs 16.6 [4.9] mm; P<.0005) and smaller diameter (2.91 [0.4] mm vs 3.04 [0.4] mm; P=.049) lesions. The median follow-up period was 26.3 (12.9) months (in 98.3 % of patients). After adjustment for other variables and for the likelihood of receiving a drug-eluting stent (ie, the propensity score), there was no significant relationship between the type of coronary stent used and either mortality or the occurrence of adverse clinical events at 1 year of follow-up.
Conclusions
With careful clinical selection of patients, the use of drug-eluting stents in octogenarians with highly unfavorable angiographic characteristics can be as safe and effective as conventional stents for treating low-risk coronary lesions.