Tags

Type your tag names separated by a space and hit enter

Long-term paclitaxel-eluting stent outcomes in elderly patients.
Circ Cardiovasc Interv. 2009 Jun; 2(3):178-87.CC

Abstract

BACKGROUND

Although drug-eluting stents have become a mainstay of percutaneous coronary intervention, information about drug-eluting stents outcomes in elderly patients is limited. Data from the paclitaxel-eluting stent (PES) trials and registries were pooled to assess PES benefits relative to advancing patient age, including comparison with bare-metal stents.

METHODS AND RESULTS

Data from 5 randomized trials (2271 patients with PES, 1397 patients with bare-metal stents) and from 2 postmarket registries (7492 patients with PES) were pooled separately. Each dataset was stratified into age groups: <60, 60 to 70, and >70 years. At baseline, patients aged >70 years in both datasets had significantly more adverse characteristics than younger patients. Through 5 years, trial data showed that patients aged >70 years had higher death rates, but comparable rates of myocardial infarction, stent thrombosis, and target lesion revascularization with younger patients. Compared with patients with bare-metal stents, patients with PES aged >70 years had comparable rates of death, myocardial infarction, and stent thrombosis but a significantly lower target lesion revascularization rate (22.2 versus 10.2, P<0.001). These findings were echoed in the registry data through 2 years that showed that PES patients aged >70 years had significantly higher death rates, but lower myocardial infarction, stent thrombosis, and target lesion revascularization rates, compared with younger patients. Although the mortality rates of patients aged >70 years were higher than those of younger patients, they were comparable with those of age- and gender-matched norms in the general population.

CONCLUSIONS

This analysis of almost 10 000 patients demonstrated that percutaneous coronary intervention with PES is a safe and an effective treatment option that should not be withheld based on age.

Authors+Show Affiliations

Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA. deforman@partners.orgNo 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)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20031714

Citation

Forman, Daniel E., et al. "Long-term Paclitaxel-eluting Stent Outcomes in Elderly Patients." Circulation. Cardiovascular Interventions, vol. 2, no. 3, 2009, pp. 178-87.
Forman DE, Cox DA, Ellis SG, et al. Long-term paclitaxel-eluting stent outcomes in elderly patients. Circ Cardiovasc Interv. 2009;2(3):178-87.
Forman, D. E., Cox, D. A., Ellis, S. G., Lasala, J. M., Ormiston, J. A., Stone, G. W., Turco, M. A., Wei, J. Y., Joshi, A. A., Dawkins, K. D., & Baim, D. S. (2009). Long-term paclitaxel-eluting stent outcomes in elderly patients. Circulation. Cardiovascular Interventions, 2(3), 178-87. https://doi.org/10.1161/CIRCINTERVENTIONS.109.855221
Forman DE, et al. Long-term Paclitaxel-eluting Stent Outcomes in Elderly Patients. Circ Cardiovasc Interv. 2009;2(3):178-87. PubMed PMID: 20031714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term paclitaxel-eluting stent outcomes in elderly patients. AU - Forman,Daniel E, AU - Cox,David A, AU - Ellis,Stephen G, AU - Lasala,John M, AU - Ormiston,John A, AU - Stone,Gregg W, AU - Turco,Mark A, AU - Wei,Jeanne Y, AU - Joshi,Anita A, AU - Dawkins,Keith D, AU - Baim,Donald S, Y1 - 2009/06/02/ PY - 2009/12/25/entrez PY - 2009/12/25/pubmed PY - 2010/3/6/medline SP - 178 EP - 87 JF - Circulation. Cardiovascular interventions JO - Circ Cardiovasc Interv VL - 2 IS - 3 N2 - BACKGROUND: Although drug-eluting stents have become a mainstay of percutaneous coronary intervention, information about drug-eluting stents outcomes in elderly patients is limited. Data from the paclitaxel-eluting stent (PES) trials and registries were pooled to assess PES benefits relative to advancing patient age, including comparison with bare-metal stents. METHODS AND RESULTS: Data from 5 randomized trials (2271 patients with PES, 1397 patients with bare-metal stents) and from 2 postmarket registries (7492 patients with PES) were pooled separately. Each dataset was stratified into age groups: <60, 60 to 70, and >70 years. At baseline, patients aged >70 years in both datasets had significantly more adverse characteristics than younger patients. Through 5 years, trial data showed that patients aged >70 years had higher death rates, but comparable rates of myocardial infarction, stent thrombosis, and target lesion revascularization with younger patients. Compared with patients with bare-metal stents, patients with PES aged >70 years had comparable rates of death, myocardial infarction, and stent thrombosis but a significantly lower target lesion revascularization rate (22.2 versus 10.2, P<0.001). These findings were echoed in the registry data through 2 years that showed that PES patients aged >70 years had significantly higher death rates, but lower myocardial infarction, stent thrombosis, and target lesion revascularization rates, compared with younger patients. Although the mortality rates of patients aged >70 years were higher than those of younger patients, they were comparable with those of age- and gender-matched norms in the general population. CONCLUSIONS: This analysis of almost 10 000 patients demonstrated that percutaneous coronary intervention with PES is a safe and an effective treatment option that should not be withheld based on age. SN - 1941-7632 UR - https://www.unboundmedicine.com/medline/citation/20031714/Long_term_paclitaxel_eluting_stent_outcomes_in_elderly_patients_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.109.855221?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -