Abstract 3656: Percutaneous Intervention in Elderly Patients with Left Main Coronary Artery Stenosis: A Single Center Experience
Background: There is limited information on mid-term outcome in elderly patients after percutaneous coronary intervention (PCI) of left main stem (LM) lesions in the era of drug eluting stents (DES).
Methods: From January 2002 to December 2005, 224 consecutive PCI patients with LM stenosis were treated with DES. Patients with ST-elevation myocardial infarction or cardiogenic shock were excluded. Patients were divided into two groups: Group A (n=123) with age above 70 years and Group B (n=101) with age below 70 years. For patients in Group A and Group B mean age was 77±5 years and 61±8 years, female gender was 31% and 21% (p=0.06), LM lesions were unprotected (no prior coronary bypass grafting) in 52% and 46%, and distal LM disease with bifurcation treatment was present in 73% and 66%. Primary endpoint was death from any cause at 30 days and during mid-term follow-up (FU).
Results: At 30 days there were no deaths in Group A and 3 deaths (3%) in Group B (p=0.09). Median FU was 370 (interquartile range 163–372) days. Kaplan-Meier cumulative 1-year mortality rates were not different between Group A and B (4.0% vs 4.4%; log-rank p=0.846). Patients in Group A had the same mid-term outcome after PCI of protected or unprotected LM disease (cumulative 1-year mortality 4.1% vs 4.0%; log-rank p=0.73). Clinically driven target vessel revascularization rate at 1 year was 3.3% for Group A and 4.0% for Group B (p=0.53).
Conclusions: Elderly patients have a favourable outcome after PCI of LM stenosis that is comparable to the outcome of younger patients. Mid-term prognosis of elderly patients is not different after PCI of protected or unprotected LM disease.