Tags

Type your tag names separated by a space and hit enter

Drug-eluting stents in the elderly: long-term (> one year) clinical outcomes of octogenarians in the DESIRE (Drug-Eluting Stents In the REal world) registry.
J Invasive Cardiol. 2008 Aug; 20(8):404-10.JI

Abstract

BACKGROUND

Despite the increasing number of elderly people, this high-complexity subset of patients is often excluded from randomized trials of percutaneous coronary intervention (PCI) and, therefore, limited data are available about their outcomes after drug-eluting stent (DES) implantation. We sought to compare the very long-term (> 1 year) clinical follow up of octogenarians treated with DES compared to younger individuals.

METHODS

The DESIRE registry is a prospective, nonrandomized, single-center registry with consecutive patients treated solely with DES between May 2002 and May 2007. The only exclusion criteria were the treatment of patients in the setting of acute myocardial infarction (MI) (< 72 hours) and lesions located in non-native coronary arteries. The primary endpoint was the occurrence of combined major adverse cardiac events (MACE) (cardiac death, non-fatal MI and target vessel revascularization) in-hospital and in very long term (> 1 year) follow up. Patients were clinically evaluated at 1, 3 and 6 months and then annually up to 5 years. Stent thrombosis was classified according to the ARC definition.

RESULTS

A total of 1,364 patients matched the inclusion/exclusion criteria and were sorted into 3 groups according to their ages: Group I = patients < 70 years of age (n = 914); Group II = patients greater than or equal to 70 and < 80 years of age (n = 334); and Group III = patients greater than or equal to 80 years old (n = 116). As expected, octogenarians had significantly more comorbid and complex anatomic lesion presentation. Nevertheless, in-hospital success was comparable among the 3 groups. Long-term (2.6 +/- 1.2 years) follow up was obtained from 97% of the total population and showed equivalent cumulative MACE in all age ranges (7.6% for < 70 years old vs. 5.4% for septuagenarians and 6.0% for octogenarians, p = 0.7). However, octogenarians had markedly more cardiac death, reflecting the severity of their comorbidity and the natural evolution of coronary disease. Of note, very few cases of stent thrombosis were noticed in the overall population (20 patients, 1.5%), with no difference among the groups.

CONCLUSIONS

PCI with DES represents an efficient and safe approach to treat coronary artery disease in the elderly, with low rates of combined MACE comparable to other age ranges.

Authors+Show Affiliations

Hospital do Coração - Associação do Sanatório Sírio, São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18688065

Citation

Costa, J Ribamar, et al. "Drug-eluting Stents in the Elderly: Long-term (> One Year) Clinical Outcomes of Octogenarians in the DESIRE (Drug-Eluting Stents in the REal World) Registry." The Journal of Invasive Cardiology, vol. 20, no. 8, 2008, pp. 404-10.
Costa JR, Sousa A, Moreira AC, et al. Drug-eluting stents in the elderly: long-term (> one year) clinical outcomes of octogenarians in the DESIRE (Drug-Eluting Stents In the REal world) registry. J Invasive Cardiol. 2008;20(8):404-10.
Costa, J. R., Sousa, A., Moreira, A. C., Costa, R. A., Maldonado, G., Cano, M. N., Egito, E. T., Romano, E. R., Barbosa, M., Pavanello, R., Jardim, C., Cury, A., Berwanger, O., & Sousa, J. E. (2008). Drug-eluting stents in the elderly: long-term (> one year) clinical outcomes of octogenarians in the DESIRE (Drug-Eluting Stents In the REal world) registry. The Journal of Invasive Cardiology, 20(8), 404-10.
Costa JR, et al. Drug-eluting Stents in the Elderly: Long-term (> One Year) Clinical Outcomes of Octogenarians in the DESIRE (Drug-Eluting Stents in the REal World) Registry. J Invasive Cardiol. 2008;20(8):404-10. PubMed PMID: 18688065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Drug-eluting stents in the elderly: long-term (> one year) clinical outcomes of octogenarians in the DESIRE (Drug-Eluting Stents In the REal world) registry. AU - Costa,J Ribamar,Jr AU - Sousa,Amanda, AU - Moreira,Adriana Costa, AU - Costa,Ricardo A, AU - Maldonado,Galo, AU - Cano,Manuel N, AU - Egito,Enilton T, AU - Romano,Edson R, AU - Barbosa,Marcos, AU - Pavanello,Ricardo, AU - Jardim,César, AU - Cury,Abrão, AU - Berwanger,Otávio, AU - Sousa,J Eduardo, PY - 2008/8/9/pubmed PY - 2009/2/3/medline PY - 2008/8/9/entrez SP - 404 EP - 10 JF - The Journal of invasive cardiology JO - J Invasive Cardiol VL - 20 IS - 8 N2 - BACKGROUND: Despite the increasing number of elderly people, this high-complexity subset of patients is often excluded from randomized trials of percutaneous coronary intervention (PCI) and, therefore, limited data are available about their outcomes after drug-eluting stent (DES) implantation. We sought to compare the very long-term (> 1 year) clinical follow up of octogenarians treated with DES compared to younger individuals. METHODS: The DESIRE registry is a prospective, nonrandomized, single-center registry with consecutive patients treated solely with DES between May 2002 and May 2007. The only exclusion criteria were the treatment of patients in the setting of acute myocardial infarction (MI) (< 72 hours) and lesions located in non-native coronary arteries. The primary endpoint was the occurrence of combined major adverse cardiac events (MACE) (cardiac death, non-fatal MI and target vessel revascularization) in-hospital and in very long term (> 1 year) follow up. Patients were clinically evaluated at 1, 3 and 6 months and then annually up to 5 years. Stent thrombosis was classified according to the ARC definition. RESULTS: A total of 1,364 patients matched the inclusion/exclusion criteria and were sorted into 3 groups according to their ages: Group I = patients < 70 years of age (n = 914); Group II = patients greater than or equal to 70 and < 80 years of age (n = 334); and Group III = patients greater than or equal to 80 years old (n = 116). As expected, octogenarians had significantly more comorbid and complex anatomic lesion presentation. Nevertheless, in-hospital success was comparable among the 3 groups. Long-term (2.6 +/- 1.2 years) follow up was obtained from 97% of the total population and showed equivalent cumulative MACE in all age ranges (7.6% for < 70 years old vs. 5.4% for septuagenarians and 6.0% for octogenarians, p = 0.7). However, octogenarians had markedly more cardiac death, reflecting the severity of their comorbidity and the natural evolution of coronary disease. Of note, very few cases of stent thrombosis were noticed in the overall population (20 patients, 1.5%), with no difference among the groups. CONCLUSIONS: PCI with DES represents an efficient and safe approach to treat coronary artery disease in the elderly, with low rates of combined MACE comparable to other age ranges. SN - 1557-2501 UR - https://www.unboundmedicine.com/medline/citation/18688065/Drug_eluting_stents_in_the_elderly:_long_term__>_one_year__clinical_outcomes_of_octogenarians_in_the_DESIRE__Drug_Eluting_Stents_In_the_REal_world__registry_ DB - PRIME DP - Unbound Medicine ER -