Second-generation drug-eluting stents in the elderly patients with acute coronary syndrome: the in-hospital and 12-month follow-up of the all-comer registryReportar como inadecuado




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Aging Clinical and Experimental Research

pp 1–9

First Online: 10 November 2016Received: 23 August 2016Accepted: 12 October 2016

Abstract

BackgroundKatowice–Zabrze registry provides data that can be used to evaluate clinical outcomes of percutaneous coronary interventions in elderly patients ≥70 y-o treated with either first- DES-I or second-generation DES-II drug-eluting stents DES.

MethodsThe registry consisted of data from 1916 patients treated with coronary interventions using either DES-I or DES-II stents. For our study, we defined patients ≥70 years of age as elderly. We evaluated any major adverse cardiac and cerebral events MACCE at 12-month follow-up.

ResultsCoronary angiography revealed a higher incidence of multivessel coronary artery disease in this elderly patient population. There were no differences in acute and subacute stent thrombosis 0.4 vs. 0.6%, p = 0.760; 0.4 vs. 0.4%; p = 0.712. Elderly patients experienced more in-hospital bleeding complications requiring blood transfusion 2.0 vs. 0.9%; p = 0.003. Resuscitated cardiac arrests 2.0 vs. 0.9%; p = 0.084 were observed more often in this elderly patients during hospitalization. The composite in-hospital MACCE rates did not differ statistically between both groups 1.4 vs. 1.1%; p = 0.567. Data from a twelve-month follow-up disclosed that mortality was higher 7.1 vs. 1.8%; p < 0.001 in the elderly, with no difference in TVR 7.2 vs. 9.9%, p = 0.075, MI 6.0 vs. 4.8%, p = 0.300, stroke 0.8 vs. 0.6%, p = 0.600 and composite MACCE 15.0 vs. 13.4%, p = 0.324. The age of 70 years or over was an independent predictor of death HR = 2.55 95% CI 1.49–4.37; p < 0.001. The use of DES-II reduced the risk of MI HR = 0.40 95% CI 0.19–0.82; p = 0.012 in the elderly.

ConclusionThis elderly patient population had an increased risk of in-hospital bleeding complications requiring blood transfusion and a higher risk of death at 12-month follow-up. The use of new-generation DES reduced the risk of MI in the elderly population.

KeywordsPercutaneous coronary intervention Drug-eluting stents Elderly patients All authors listed meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors, and all authors are in agreement with the manuscript.

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Autor: Wojciech Wańha - Damian Kawecki - Tomasz Roleder - Beata Morawiec - Sylwia Gładysz - Adam Kowalówka - Tomasz Jadczyk - B

Fuente: https://link.springer.com/







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