"Do least harm" philosophy may suffice for percutaneous coronary intervention in octogenarians

Marco L. Rossi, Guido Belli, Dennis Zavalloni Parenti, Melania Scatturin, Paolo Pagnotta, Gabriele Gasparini, Patrizia Presbitero

Research output: Contribution to journalArticle

Abstract

Background: Octogenarians represent one of the most rapidly expanding segments of the population and an ever growing number are undergoing percutaneous coronary intervention (PCI). A simplified approach with incomplete or "culprit-lesion" only PCI may be an option even in multivessel disease, to minimize periprocedural complications while still allowing a meaningful clinical recovery in patients with inherent functional limitations related to age itself. We tried to determine the effects of either complete or partial PCI on procedural and long-term outcome in a consecutive series of octogenarians. Methods: In-hospital and 1-year clinical outcomes were collected in elderly patients treated with PCI between January 1998 and March 2004 in our institution. Results: In a total of 165 octogenarians, 73 elderly patients (44%) underwent complete (COM) and 92 (56%) incomplete (INC) revascularization. Major in-hospital cardiac events were similar in the two subgroups. At 1-year follow-up 65% of patients in the COM and 68% in the INC group (P = ns) referred improvement in angina status and quality of life. Clinically driven repeat PCI was necessary in 16% of COM and 15% of INC patients. Recurrent PCI was mostly required to treat a restenotic index lesion in both groups, while only five patients in the INC group (5.4%) required PCI of a different lesion. Conclusions: Current PCI coronary techniques are safe and effective in octogenarians. Restenosis remains the main cause for recurrent events after bare metal stents. Percutaneous revascularization limited to the culprit lesion may suffice in most patients, with favorable clinical outcome at 1 year.

Original languageEnglish
Pages (from-to)313-318
Number of pages6
JournalJournal of Interventional Cardiology
Volume19
Issue number4
DOIs
Publication statusPublished - Aug 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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