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One-year results of coronary artery stenting in elderly patients

https://doi.org/10.15829/1560-4071-2013-1-58-64

Abstract

Aim. To study the one-year survival after coronary artery stenting (CAS) across age groups and to identify the predictors of cardiovascular events registered during the follow-up period.

 

Material and methods. In total, 662 patients who underwent CAS were divided into 4 groups: Group I – under 60 years (n=363); Group II – 60–64 years (n=140); Group III – 65–69 years (n=88); Group IV – 70+ years (n=71). The end-points, registered during the one-year follow-period, included death, myocardial infarction (MI), stroke (S), repeat revascularisation, and their combinations. In addition, the pre- and peri-intervention predictors of the abovementioned cardiovascular events were analysed.

 

Results. Based on the one-year follow-up data, there was an insignificant increase in all-cause mortality among older patients. However, the difference in cardiovascular mortality across the groups was statistically significant (p for trend 0,04). In multivariate regression analyses, age was not independently associated with the risk of cardiovascular death, while atherogenic index, decreased left ventricular contractility, and post-intervention renal dysfunction were independent predictors of cardiovascular mortality. The independent predictors of combined end-point were circulatory support duration, peri-intervention S, and the lesions in two or more coronary arteries.

 

Conclusion. In one year after CAS, 65–69-year-old patients demonstrated higher cardiovascular mortality levels, with no apparent increase in all-cause mortality and the incidence of combined end-point. Age was not an independent predictor of the one-year risk of cardiovascular events.

About the Authors

A. N. Sumin
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


R. A. Gaifullin
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


S. V. Ivanov
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


E. V. Korok
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


A. V. Shcheglova
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


M. G. Mos’kin
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


O. L. Barbarash
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


L. S. Barbarash
Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo, Russia
Russian Federation


References

1. Wiedemann D, Bernhard D, Laufer G, Kocher A. The elderly patient and cardiac surgery – a mini-review. Gerontology. 2010; 56 (3):241–9.

2. Li Z, Amsterdam EA, Yeo KK, et al. Coronary Artery Bypass Operations for Elderly Patients in California, 2003 to 2008. Ann Thorac Surg. 2012;93 (4):1167–72.

3. Olofinskaja I. E. Heart surgery with extracorporeal circulation in elderly patients: risk factors, prognosis. Kardiologija. 2008; 8:76–81. Russian. (Олофинская И. Е. Операции на сердце с искусственным кровообращением у больных пожилого возраста: факторы риска, прогноз. Кардиология. 2008; 8:76–81).

4. Iung B, Cachier A, Baron G, et al. Decision making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J 2005; 26: 2714–20.

5. Gohlke H. Is it ever too late for cardiovascular prevention and rehabilitation? Oral presentation. EuroPrevent, Praha, 2010

6. Yanagawa B, Algarni KD, Yau TM, et al. Improving results for coronary artery bypass graft surgery in the elderly. Eur J Cardiothorac Surg. 2012 Jan 13. (Epub ahead of print)

7. Sumin A. N., Gajfulin R. A., Evdokimov D. O., et al. Effect of advanced age on the risk of perioperative complications in operations on non-coronary vascular beds. Adv Gerontol. 2012; 1:143–51. Russian (Сумин А. Н., Гайфулин Р. А., Евдокимов Д. О., и др. Влияние пожилого возраста на риск периоперационных осложнений при операциях на некоронарных сосудистых бассейнах. Успехи геронтологии. 2012; 1:143–51).

8. Fukui T, Tabata M, Matsuyama S, Takanashi S. Graft selection in elderly patients undergoing coronary artery bypass grafting. Gen Thorac Cardiovasc Surg. 2011; 59 (12):786–92.

9. van Straten AH, Firanescu C, Soliman Hamad MA, et al. Peripheral vascular disease as a predictor of survival after coronary artery bypass grafting: comparison with a matched general population. Ann Thorac Surg. 2010; 89 (2):414–20.

10. Barbarash LS, Shafranskaja KS, Ivanov SV, et al. Ability to use a modified scale EUROSCORE to assess the annual forecast of coronary artery bypass grafting in patients with multifocal atherosclerosis. Patologija krovoobraschenija i kardiohirurgija. 2010; 2:52–6. Russian. (Барбараш ЛС, Шафранская КС, Иванов СВ, и др. Возможность использования модифицированной шкалы EUROSCORE для оценки годового про-

11. гноза коронарного шунтирования у пациентов с мультифокальным атеросклерозом. Патология кровообращения и кардиохирургия. 2010; 2:52–6)

12. Kulik A, Ruel M. Lipid-lowering therapy and coronary artery bypass graft surgery: what are the benefits? Curr Opin Cardiol. 2011;26 (6):508–17.

13. Kalavrouziotis D, Buth KJ, Cox JL, Baskett RJ. Should all patients be treated with an angiotensin-converting enzyme inhibitor after coronary artery bypass graft surgery? The impact of angiotensin-converting enzyme inhibitors, statins, and

14. Kulik A, Voisine P, Mathieu P, et al. Statin therapy and saphenous vein graft disease after coronary bypass surgery: analysis from the CASCADE randomized trial. Ann Thorac Surg. 2011;92 (4):1284–90.

15. Margaritis M, Channon KM, Antoniades C. Statins and vein graft failure in coronary bypass surgery. Curr Opin Pharmacol. 2012 Feb 10. (Epub ahead of print)

16. Kulik A, Shrank WH, Levin R, Choudhry NK Adherence to statin therapy in elderly patients after hospitalization for coronary revascularization. Am J Cardiol. 2011 May 15;107 (10):1409–14.

17. Vasques F, Rainio A, Heikkinen J, et al. Off-pump versus on-pump coronary artery bypass surgery in patients aged 80 years and older: institutional results and meta-analysis. Heart Vessels. 2011 Nov 9. (Epub ahead of print)

18. Saxena A, Dinh DT, Yap CH, et al. Critical analysis of early and late outcomes after isolated coronary artery bypass surgery in elderly patients. Ann Thorac Surg. 2011;92 (5):1703–11.

19. Ghanta RK, Shekar PS, McGurk S, et al. Long-term survival and quality of life justify cardiac surgery in the very elderly patient. Ann Thorac Surg. 2011;92 (3):851–7.

20. Baravelli M, Picozzi A, Rossi A, et al. Major epidemiological changes and clinical variables in patients undergoing a program of heart rehabilitation after cardiac surgery –MEPHISTOPHELES. G Ital Cardiol (Rome). 2011;12 (9):611–8.


Review

For citations:


Sumin A.N., Gaifullin R.A., Ivanov S.V., Korok E.V., Shcheglova A.V., Mos’kin M.G., Barbarash O.L., Barbarash L.S. One-year results of coronary artery stenting in elderly patients. Russian Journal of Cardiology. 2013;(1):58-64. (In Russ.) https://doi.org/10.15829/1560-4071-2013-1-58-64

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ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)