TY - JOUR
T1 - Sirolimus-eluting coronary stents in octogenarians
T2 - A 1-year analysis of the worldwide e-select registry
AU - Hong, Young Joon
AU - Jeong, Myung Ho
AU - Abizaid, Alexander
AU - Banning, Adrian
AU - Bartorelli, Antonio
AU - Dzavik, Vladimir
AU - Ellis, Stephen G.
AU - Gao, Runlin
AU - Holmes, David R.
AU - Legrand, Victor
AU - Neumann, Franz Josef
AU - Spaulding, Christian
AU - Worthley, Stephen
AU - Urban, Philip
PY - 2011/9
Y1 - 2011/9
N2 - Objectives: The aim of this study was to identify the worldwide practice of Cypher Select (Cordis Corporation, Bridgewater, New Jersey) or Cypher Select Plus sirolimus-eluting stent (SES) in patients 80 years of age (octogenarian) and to identify clinical outcomes in this patient population. Background: The use of drug-eluting stents in elderly patients may have different features compared with younger patients. Methods: Between 2006 and 2008, 15,147 patients from 320 hospitals in 56 countries were enrolled in a registry. Initial implantation and follow-up outcome information obtained at 1-year follow-up in 675 octogenarian patients were compared with those in 14,472 nonoctogenarian patients. Results: Octogenarians had significantly more comorbidities and had higher Charlson comorbidity index scores (1.5 ± 1.6 vs. 1.0 ± 1.3, p <0.001). Rates of cardiac death (3.3% vs. 0.9%, p <0.001), myocardial infarction (2.3% vs. 1.9%, p = 0.021), and definite or probable stent thrombosis (2.3% vs. 0.9%, p = 0.0002), and major bleeding (2.0% vs. 0.9%, p = 0.015) were significantly higher in octogenarians at 1 year; however, there was no significant difference in the rate of target lesion revascularization between the 2 groups (3.2% vs. 2.2%, p = 0.12). In octogenarians, a high Charlson comorbidity index was an independent predictor of death and stent thrombosis up to 360 days from the index procedure (hazard ratio: 1.3, 95% confidence interval: 1.1 to 1.5, p <0.001, and hazard ratio: 1.5, 95% confidence interval: 1.3 to 1.8, p <0.001, respectively). Conclusions: Stenting with SES may be an effective therapeutic option in elderly patients, with acceptable rates of complications and a very low rate of repeat revascularization as demonstrated by this e-SELECT (A Multi-Center Post-Market Surveillance Registry) subgroup analysis.
AB - Objectives: The aim of this study was to identify the worldwide practice of Cypher Select (Cordis Corporation, Bridgewater, New Jersey) or Cypher Select Plus sirolimus-eluting stent (SES) in patients 80 years of age (octogenarian) and to identify clinical outcomes in this patient population. Background: The use of drug-eluting stents in elderly patients may have different features compared with younger patients. Methods: Between 2006 and 2008, 15,147 patients from 320 hospitals in 56 countries were enrolled in a registry. Initial implantation and follow-up outcome information obtained at 1-year follow-up in 675 octogenarian patients were compared with those in 14,472 nonoctogenarian patients. Results: Octogenarians had significantly more comorbidities and had higher Charlson comorbidity index scores (1.5 ± 1.6 vs. 1.0 ± 1.3, p <0.001). Rates of cardiac death (3.3% vs. 0.9%, p <0.001), myocardial infarction (2.3% vs. 1.9%, p = 0.021), and definite or probable stent thrombosis (2.3% vs. 0.9%, p = 0.0002), and major bleeding (2.0% vs. 0.9%, p = 0.015) were significantly higher in octogenarians at 1 year; however, there was no significant difference in the rate of target lesion revascularization between the 2 groups (3.2% vs. 2.2%, p = 0.12). In octogenarians, a high Charlson comorbidity index was an independent predictor of death and stent thrombosis up to 360 days from the index procedure (hazard ratio: 1.3, 95% confidence interval: 1.1 to 1.5, p <0.001, and hazard ratio: 1.5, 95% confidence interval: 1.3 to 1.8, p <0.001, respectively). Conclusions: Stenting with SES may be an effective therapeutic option in elderly patients, with acceptable rates of complications and a very low rate of repeat revascularization as demonstrated by this e-SELECT (A Multi-Center Post-Market Surveillance Registry) subgroup analysis.
KW - coronary artery disease
KW - hemorrhagic complication
KW - octogenarian
KW - percutaneous coronary intervention
KW - sirolimus-eluting stent
KW - stent thrombosis
UR - http://www.scopus.com/inward/record.url?scp=80053042010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053042010&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2011.06.013
DO - 10.1016/j.jcin.2011.06.013
M3 - Article
C2 - 21939938
AN - SCOPUS:80053042010
VL - 4
SP - 982
EP - 991
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
SN - 1936-8798
IS - 9
ER -