Percutaneous coronary intervention in the elderly.

Published

Journal Article (Review)

In contemporary practice, more than one in five patients treated with percutaneous coronary intervention (PCI) are aged ≥75 years and the proportion of elderly individuals in the population is growing. The elderly have more cardiovascular risk factors and a greater burden of ischemic disease than younger patients needing PCI and, therefore, derive greater benefit from revascularization. However, they are also more likely to experience procedural complications, owing to age-related physiological changes, frailty, and comorbidities. This article reviews the outcomes of revascularization among the elderly and the impact of advances in PCI techniques and adjuvant pharmacotherapy on these outcomes. We also address clinical challenges that exist presently when considering PCI in the elderly, as well as future research needs to optimize revascularization outcomes in this population. To maximize the benefits of PCI in the elderly, providers should have explicit conversations with patients regarding goals of treatment. Once a decision to undergo PCI is reached, clinicians need to individualize care decisions, address modifiable risks such as bleeding, and pay careful attention to selection of the appropriate timing of PCI, and the type, timing, and dosing of adjuvant medical therapy.

Full Text

Duke Authors

Cited Authors

  • Wang, TY; Gutierrez, A; Peterson, ED

Published Date

  • February 2011

Published In

Volume / Issue

  • 8 / 2

Start / End Page

  • 79 - 90

PubMed ID

  • 21139558

Pubmed Central ID

  • 21139558

Electronic International Standard Serial Number (EISSN)

  • 1759-5010

International Standard Serial Number (ISSN)

  • 1759-5002

Digital Object Identifier (DOI)

  • 10.1038/nrcardio.2010.184

Language

  • eng