Second-generation drug-eluting stents in the elderly patients with acute coronary syndrome: the in-hospital and 12-month follow-up of the all-comer registry.

Autor: Wańha W; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland. wojciech.wanha@gmail.com., Kawecki D; Second Division of Cardiology, Medical University of Silesia, Zabrze, Poland., Roleder T; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland., Morawiec B; Second Division of Cardiology, Medical University of Silesia, Zabrze, Poland., Gładysz S; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland., Kowalówka A; Division of Cardiothoracic Surgery, Medical University of Silesia, Katowice, Poland., Jadczyk T; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland., Adamus B; Division of Cardiology, Specialist Hospital, Wilkowice, Poland., Pawłowski T; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland., Smolka G; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland., Kaźmierski M; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland., Ochała A; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland., Nowalany-Kozielska E; Second Division of Cardiology, Medical University of Silesia, Zabrze, Poland., Wojakowski W; Third Division of Cardiology, Medical University of Silesia, Katowice, Poland.
Jazyk: angličtina
Zdroj: Aging clinical and experimental research [Aging Clin Exp Res] 2017 Oct; Vol. 29 (5), pp. 885-893. Date of Electronic Publication: 2016 Nov 10.
DOI: 10.1007/s40520-016-0649-8
Abstrakt: Background: Katowice-Zabrze registry provides data that can be used to evaluate clinical outcomes of percutaneous coronary interventions in elderly patients (≥70 y/o) treated with either first- (DES-I) or second-generation (DES-II) drug-eluting stents (DES).
Methods: The registry consisted of data from 1916 patients treated with coronary interventions using either DES-I or DES-II stents. For our study, we defined patients ≥70 years of age as elderly. We evaluated any major adverse cardiac and cerebral events (MACCE) at 12-month follow-up.
Results: Coronary angiography revealed a higher incidence of multivessel coronary artery disease in this elderly patient population. There were no differences in acute and subacute stent thrombosis (0.4 vs. 0.6%, p = 0.760; 0.4 vs. 0.4%; p = 0.712). Elderly patients experienced more in-hospital bleeding complications requiring blood transfusion (2.0 vs. 0.9%; p = 0.003). Resuscitated cardiac arrests (2.0 vs. 0.9%; p = 0.084) were observed more often in this elderly patients during hospitalization. The composite in-hospital MACCE rates did not differ statistically between both groups (1.4 vs. 1.1%; p = 0.567). Data from a twelve-month follow-up disclosed that mortality was higher (7.1 vs. 1.8%; p < 0.001) in the elderly, with no difference in TVR (7.2 vs. 9.9%, p = 0.075), MI (6.0 vs. 4.8%, p = 0.300), stroke (0.8 vs. 0.6%, p = 0.600) and composite MACCE (15.0 vs. 13.4%, p = 0.324). The age of 70 years or over was an independent predictor of death [HR = 2.55 (95% CI 1.49-4.37); p < 0.001]. The use of DES-II reduced the risk of MI [HR = 0.40 (95% CI 0.19-0.82); p = 0.012] in the elderly.
Conclusion: This elderly patient population had an increased risk of in-hospital bleeding complications requiring blood transfusion and a higher risk of death at 12-month follow-up. The use of new-generation DES reduced the risk of MI in the elderly population.
Databáze: MEDLINE
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