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Multicenter experience in revascularization of very elderly patients.

Publication ,  Journal Article
Peterson, ED; Alexander, KP; Malenka, DJ; Hannan, EL; O'Conner, GT; McCallister, BD; Weintraub, WS; Grover, FL ...
Published in: Am Heart J
September 2004

BACKGROUND: Very elderly patients are increasingly referred for revascularization yet have been underrepresented in both prior percutaneous coronary intervention (PCI) and coronary bypass surgery (CABG) clinical trials. We pooled the largest PCI and CABG clinical registries in the United States to better understand revascularization procedure use, risks and outcomes in patients aged > or =75 years. METHODS: Six PCI registries (n = 48,439) and 8 CABG registries (n = 180,709) voluntarily contributed all procedural data in patients aged > or =75 years from 1990 through 1999. Patient characteristics, procedural process, and inhospital mortality and morbidity outcomes were evaluated. Risk factors for mortality in elderly patients were identified and compared across registries using standardized multivariable logistic regression. RESULTS: Between the years 1991 and 1999, the proportion of patients aged > or =75 years undergoing revascularization was on the rise (10% increase). Pooled estimates of inhospital mortality following PCI during this decade was 3.0% (range 1.5%-5.2% among databases), and following CABG was 5.9% (range 4.9%-8.4% among databases). Mortality rates declined significantly in older patients for both PCI and CABG over this decade. While process measures varied across registries, the most significant predictors of inhospital death (procedural urgency, left ventricular dysfunction, prior CABG) seemed consistent across all sites. CONCLUSION: Over the last decade, the use of coronary revascularization in elderly patients increased and outcomes improved. While age remains a determinant of procedural risk, this risk varies markedly among elderly patients, emphasizing the need for individualized risk assessments.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

September 2004

Volume

148

Issue

3

Start / End Page

486 / 492

Location

United States

Related Subject Headings

  • United States
  • Registries
  • Male
  • Humans
  • Hospital Mortality
  • Female
  • Coronary Disease
  • Coronary Artery Bypass
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary
 

Citation

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Peterson, E. D., Alexander, K. P., Malenka, D. J., Hannan, E. L., O’Conner, G. T., McCallister, B. D., … American Heart Association Chronic CAD Working Group, . (2004). Multicenter experience in revascularization of very elderly patients. Am Heart J, 148(3), 486–492. https://doi.org/10.1016/j.ahj.2004.03.039
Peterson, Eric D., Karen P. Alexander, David J. Malenka, Edward L. Hannan, Gerald T. O’Conner, Ben D. McCallister, William S. Weintraub, Fred L. Grover, and Fred L. American Heart Association Chronic CAD Working Group. “Multicenter experience in revascularization of very elderly patients.Am Heart J 148, no. 3 (September 2004): 486–92. https://doi.org/10.1016/j.ahj.2004.03.039.
Peterson ED, Alexander KP, Malenka DJ, Hannan EL, O’Conner GT, McCallister BD, et al. Multicenter experience in revascularization of very elderly patients. Am Heart J. 2004 Sep;148(3):486–92.
Peterson, Eric D., et al. “Multicenter experience in revascularization of very elderly patients.Am Heart J, vol. 148, no. 3, Sept. 2004, pp. 486–92. Pubmed, doi:10.1016/j.ahj.2004.03.039.
Peterson ED, Alexander KP, Malenka DJ, Hannan EL, O’Conner GT, McCallister BD, Weintraub WS, Grover FL, American Heart Association Chronic CAD Working Group. Multicenter experience in revascularization of very elderly patients. Am Heart J. 2004 Sep;148(3):486–492.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

September 2004

Volume

148

Issue

3

Start / End Page

486 / 492

Location

United States

Related Subject Headings

  • United States
  • Registries
  • Male
  • Humans
  • Hospital Mortality
  • Female
  • Coronary Disease
  • Coronary Artery Bypass
  • Cardiovascular System & Hematology
  • Angioplasty, Balloon, Coronary