geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Survival after coronary revascularization in the elderly


, : Survival after coronary revascularization in the elderly. Circulation 105(20): 2378-2384, May 21

Background-Elderly patients with ischemic heart disease are increasingly referred for coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). However, reports of poor outcomes in the elderly have led to questions about the benefit of these strategies. We studied survival by prescribed treatment (CABG, PCI, or medical therapy) for patients in 3 age categories: <70 years, 70 to 79 years, and gtoreq80 years of age. Methods and Results-The Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) is a clinical data collection and outcome monitoring initiative capturing all patients undergoing cardiac catheterization and revascularization in the province of Alberta, Canada, since 1995. Characteristics and long-term outcomes of a cohort of >6000 elderly patients with ischemic heart disease were compared with younger patients. In 15 392 patients >70 years of age, 4-year adjusted actuarial survival rates for CABG, PCI, and medical therapy were 95.0%, 93.8%, and 90.5%, respectively. In 5198 patients 70 to 79 years of age, survival rates were 87.3%, 83.9%, and 79.1%, respectively. In 983 patients gtoreq80 years of age, survival was 77.4% for CABG, 71.6% for PCI, and 60.3% for medical therapy. Absolute risk differences in comparison to medical therapy for CABG (17.0%) and PCI (11.3%) were greater for patients gtoreq80 years of age than for younger patients. Conclusions-Elderly patients paradoxically have greater absolute risk reductions associated with surgical or percutaneous revascularization than do younger patients. The combination of these results with a recent randomized trial suggests that the benefits of aggressive revascularization therapies may extend to subsets of patients in older age groups.

US$19.90

PMID: 12021224

DOI: 10.1016/s1062-1458(02)00970-4


Other references

Raeder, J.; Nordentoft, Jørgen., 2010: Ambulatory surgery and anaesthesia. Most surgical procedures in Norway are performed on an ambulatory basis. Many types of health professionals are involved and need training in how to handle these patients. The paper reviews important aspects of handling ambulatory surgical patient...

Kawakatsu, H., 2012: Geophysics. At the bottom of the oceanic plate. High-resolution seismic maps are providing a better picture of the processes involved in plate tectonics.

Lasich, M.; Ramjugernath, D., 2017: Influence of fluorination on barrier properties of polymers: Insights from Monte Carlo simulations of eicosanes + methane. Fluorination is widely used to improve the resistance and physical properties of polymers that are cheap to manufacture. This process improves the resistance properties of unfluorinated materials. This study examines the effects of varying the deg...

Barrière, H.; Litoux, P.; Bureau, B.; Welin, J.; Stalder, J.F.; Roubeix, Y., 1977: Epithelioma occurring on chronic leg ulcers. The authors report nine cases of epithelioma occuring on chronic leg ulcers of venous origin (6), or on fistula from chronic osteitis (3). Compared with the other trophic leg ulcers observed during the same period, the risk of malignant change app...

Kovács, E.; Mazarean, H.H., 1967: Inhibition of catalase activity with ascorbic acid in different substrate concentrations. Arzneimittel-Forschung 17(6): 761-763

Schuder, J.C.; Gold, J.H.; McDaniel, W.C., 1982: Ultrahigh-energy hydrogen thyratron/SCR bidirectional waveform defibrillator. Medical & Biological Engineering & Computing 20(4): 419-424

Beal, Peter A., 2002: RNA-editing by adenosine deamination. Abstracts of Papers American Chemical Society 224(1-2): BIOL 107

Schaider, H.; Kaddu, S.; Heider, K.H.; Soyer, H.P.; Kerl, H., 1997: Expression of CD44-splice variant v6 in trichoblastomas, basal-cell carcinomas, and squamous-cell carcinomas No correlation with malignancy. Journal of Cutaneous Pathology 24(2): 122

Nehlig, A.; Sperling, M.; Mathern, G., 2017: An interview with Tiwalade Sobayo, 2017 Epilepsia Prize Winner for Basic Science Research. Epilepsia 58(7): 1115-1116

Nich, C.; Bonnin, P.; Laredo, J.D.; Sedel, L., 2005: An uncommon form of delayed radio-induced brachial plexopathy. Radiation therapy of the neck or axillary areas for cancer may result in delayed brachial plexus palsy. Differential diagnosis between radiation and tumor brachial plexopathy is difficult. We report the case of a 38-year-old woman, treated by radi...