Percutaneous Coronary Intervention Is More Beneficial Than Optimal Medical Therapy in Elderly Patients with Angina Pectoris
Yonsei Medical Journal
; : 382-387, 2016.
Article
in En
| WPRIM
| ID: wpr-21019
Responsible library:
WPRO
ABSTRACT
PURPOSE:
Data comparing the clinical benefits of medical treatment with those of percutaneous coronary intervention (PCI) in an elderly population with angina pectoris are limited. Therefore, we evaluated the efficacy of elective PCI versus optimal medical treatment (OMT) in elderly patients (between 75 and 84 years old) with angina pectoris. MATERIALS ANDMETHODS:
One hundred seventy-seven patients with significant coronary artery stenosis were randomly assigned to either the PCI group (n=90) or the OMT group (n=87). The primary outcome was a composite of major adverse events in the 1-year follow-up period that included cardiovascular death, non-fatal myocardial infarction, coronary revascularization, and stroke.RESULTS:
Major adverse events occurred in 5 patients (5.6%) of the PCI group and in 17 patents (19.5%) of the OMT group (p=0.015). There were no significant differences between the PCI group and the OMT group in cardiac death [hazard ratio (HR) for the PCI group 0.454; 95% confidence interval (CI) 0.041-5.019, p=0.520], myocardial infarction (HR 0.399; 95% CI 0.039-4.050, p=0.437), or stroke (HR 0.919; 95% CI 0.057-14.709, p=0.952). However, the PCI group showed a significant preventive effect of the composite of major adverse events (HR 0.288; 95% CI 0.106-0.785, p=0.015) and against the need for coronary revascularization (HR 0.157; 95% CI 0.035-0.703, p=0.016).CONCLUSION:
Elective PCI reduced major adverse events and was found to be an effective treatment modality in elderly patients with angina pectoris and significant coronary artery stenosis, compared to OMT.Key words
Full text:
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Index:
WPRIM
Main subject:
Proportional Hazards Models
/
Prospective Studies
/
Treatment Outcome
/
Stroke
/
Coronary Stenosis
/
Republic of Korea
/
Percutaneous Coronary Intervention
/
Angina Pectoris
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Myocardial Infarction
Type of study:
Observational_studies
Limits:
Aged
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Aged80
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Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Yonsei Medical Journal
Year:
2016
Type:
Article