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Benefits on coronary restenosis from elective paclitaxel-eluting stent implantation in patients aged 75 years and older

Sardella, Gennaro; Luca, Leonardo De; Persio, Giovanni De; Colantonio, Riccardo; Petrolini, Alessandro; Conti, Giulia; Fedele, Francesco

Journal of Cardiovascular Medicine: July 2007 - Volume 8 - Issue 7 - p 494–498
doi: 10.2459/01.JCM.0000278442.81741.d2
Original articles
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Objective Elderly patients are increasingly referred for revascularisation yet have been underrepresented in some large clinical trials. Although the advent of drug-eluting stents has dramatically reduced clinical events related to restenosis, older age remains one of the most important correlates of adverse outcome, even after an elective percutaneous coronary intervention (PCI). We sought to evaluate the impact of paclitaxel-eluting stents on coronary restenosis in elderly patients undergoing elective PCI.

Methods Patients undergoing successful elective PCI with stenting of de novo coronary artery lesions were identified and screened for participation in this study. All patients included in our analysis were divided into two cohort groups: patients aged <75 years (younger cohort) and patients aged ≥75 years (elderly cohort). We evaluated the six-month incidence of target lesion revascularisation (TLR) and major adverse cardiac events, which included TLR, death and myocardial infarction.

Results A total of 171 (58 aged ≥75 years) consecutive patients were enrolled in the study. At six months, TLR rate was similar in both groups [1.77 vs. 1.72%, odds ratio (OR) 0.97, 95% confidence interval (CI) 0.08–10.9, P = 0.98, in the younger and elderly group, respectively]. Even the rate of major adverse cardiac events was comparable between the two groups (7.96 vs. 8.62%, OR 1.09, 95% CI 0.34–3.41, P = 0.88, in the younger and elderly group, respectively). Also the angiographic restenosis rates were comparable between patients <75 or ≥75 years (4.42 vs. 3.46%, P = 0.76).

Conclusions After elective paclitaxel-eluting stent implantation, there is no difference in coronary restenosis in younger and elderly patients, suggesting an age-independent efficacy.

aDepartment of Cardiovascular and Respiratory Sciences, ‘La Sapienza’ University, Rome, Italy

bLaboratory of Interventional Cardiology, Division of Cardiology, European Hospital, Rome, Italy

Received 15 May, 2006

Accepted 22 June, 2006

Correspondence to Dr Gennaro Sardella, Department of Cardiovascular and Respiratory Sciences, ‘La Sapienza’ University, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy Tel: +39 06 49979044; fax: +39 06 49979060; e-mail: rino.sardella@uniroma1.it

© 2007 Italian Federation of Cardiology. All rights reserved.