Document Detail

Incomplete revascularization in the drug eluting stent era permits meaningful long-term (12-78 months) outcomes in patients ≥ 75 years with acute coronary syndrome.
MedLine Citation:
PMID:  23341837     Owner:  NLM     Status:  PubMed-not-MEDLINE    
OBJECTIVE: To compare long-term prognosis between complete revascularization (CR) and incomplete revascularization (IR) in elderly patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI).
METHODS: We prospectively enrolled patients ≥ 75 years with ACS and multi-lesion disease between January 2005 and December 2010 at our center (Institute of Geriatric Cardiology, Chinese PLA General Hospital). Baseline clinical characteristics, PCI parameters and long-term (12 to 78 months) outcomes including main adverse cardiac and cerebral events (MACCE) were compared between CR and IR groups. We used the Kaplan-Meier curve to describe the survival rates, and variables reported to be associated with prognosis were included in Cox regression.
RESULTS: Of the 502 patients, 230 patients obtained CR, and the other 272 patients underwent IR. Higher SYNTAX score was an independent predictor of IR [Odds ratio (OR): 1.141, 95% confidence interval (95% CI): 1.066-1.221, P = 0.000]. A total of 429 patients (85.5%) were followed with a duration ranging from 12 months to 78 months. There were no significant differences in cumulative survival rates and event free survival rates between the two groups, even for patients with multi-vessel disease. Older age (OR: 1.079, 95% CI: 1.007-1.157, P = 0.032), prior myocardial infarction (OR: 1.440, 95% CI: 1.268-2.723, P = 0.001) and hypertension (OR: 1. 653, 95% CI: 1.010-2.734, P = 0.050) were significant independent predictors of long-term MACCE.
CONCLUSIONS: Given that both clinical and coronary lesion characteristics are much more complex in patients ≥75 years with ACS and multi-lesion disease, IR may be an option allowing low risk hospital results and meaningful long-term (12 to 78 months) outcomes.
Jie Chen; Qiao Xue; Jing Bai; Lei Gao; Jin-Wen Tian; Ke Li; Qiang Xu; Yan-Hua Li; Yu Wang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of geriatric cardiology : JGC     Volume:  9     ISSN:  1671-5411     ISO Abbreviation:  J Geriatr Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-01-23     Completed Date:  2013-01-24     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101237881     Medline TA:  J Geriatr Cardiol     Country:  China    
Other Details:
Languages:  eng     Pagination:  336-43     Citation Subset:  -    
Institute of Geriatric Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, 100853 Beijing, China.
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