Long-term results after successful percutaneous transluminal coronary angioplasty in patients over 75 years of age.

ABSTRACT

A prospective study comparing the long-term results of balloon angioplasty in patients over 75 years of age with those in a younger patient group is not available. A total of 192 consecutive patients aged > or = 75 years (group I) who underwent a balloon angioplasty were matched with 192 control patients aged 40 to 65 years (group II). The groups were matched for gender, angina pectoris class, left ventricular function, 1-, 2-, and 3-vessel coronary artery disease, and previous myocardial infarction. The mean follow-up was 40.4 months (range 0 to 110). Actuarial analysis (freedom from events) after 5 years yielded the following results for group I versus group II free from death remained 77.1% versus 97.9% (p = 0.0001), from cardiac death 92.4% versus 97.9% (p = 0.049), and from angina pectoris 54.6% versus 75.1% (p = 0.03). The differences were not significant for those remaining free from myocardial infarction, repeat balloon angioplasty, or coronary artery bypass grafting. When elderly patients with complete revascularization (n = 127) were compared with a matched control group of 127 patients aged 40 to 65 years who underwent complete revascularization, there was only a significant difference in noncardiac death rates. We conclude that patients > 75 years of age have a significant higher cardiac and noncardiac death rate and a higher incidence of angina pectoris after successful balloon angioplasty. However, the incidence of reintervention and myocardial infarction is lower in the elderly. If complete revascularization is achieved in the elderly, then freedom from cardiac death and recurrence of angina pectoris would be comparable to that in younger patients.