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Benefits of DES may be applicable to elderly patients
Octogenarians who undergo PCI with drug-eluting stents have an increased mortality risk but a lower rate of repeat revascularization, study results suggest.
Researchers studied 6,129 consecutive patients (4.7% octogenarians) who underwent PCI with DES at a single center in the Netherlands from 2000 to 2005.
Octogenarians had a higher mortality rate at 30 days (adjusted HR=1.92; 95% CI, 1.23-3.01) and 4 years (adjusted HR=2.25; 95% CI, 1.77-2.85). However, this population also had lower target lesion revascularization rates (63.2 vs. 32.6 per 1,000 person-years at 1 year and 27.9 vs. 16.6 per 1,000 person-years at 4 years) and vessel revascularization rates (83.1 vs. 52.9 per 1,000 person-years at 1 year and 37.7 vs. 25 per 1,000 person-years at 4 years).
When comparing DES with bare-metal stents, mortality and MI rates were comparable, but patients who received a DES had a significantly lower incidence of TLR at 1-year (9.5 vs. 0.6 per 1,000 person-years; adjusted HR=0.07; 95% CI, 0.01-0.57) and 4-year follow-up (3.4 vs. 0.7 per 1,000 person-years; adjusted HR=0.16; 95% CI, 0.04-0.59).
The adjusted HR of all-cause death in relation to age was fairly constant throughout the entire follow-up period and was similar in the periprocedural phase and afterward, researchers said.
“This observation suggests that age should be a factor to be considered when evaluating risk in patients undergoing PCI with stenting, but age in itself should not be considered a contraindication for that procedure,” they said.