Abstract 6017: Long-Term TAXUS Paclitaxel-Eluting Stent Outcomes in the Elderly Patients
Although percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is widely used for treating elderly patients (pts), there are limited data regarding PCI outcomes in this high-risk patient population. To determine the impact of age on long-term safety and efficacy following implantation of the TAXUS Express2 paclitaxel-eluting stent, we analyzed the TAXUS and ARRIVE studies. The 2,797 pts in TAXUS I, II SR, IV and V randomized trials and 7,492 pts in ARRIVE 1 and 2 “real world” registries were divided into three groups based on age: <60, 60 –70 and >70 years. Safety and efficacy outcomes were compared among these age groups.
Results: While the 5-year death rate increased with age in the TAXUS trials, the rates of target lesion revascularization (TLR) and myocardial infarction (MI) were comparable, and the rate of stent thrombosis (ST) decreased with age. Moreover, the bare metal stent pts >70 (not shown) had similar rates of death and MI and a higher rate of TLR and ST than the corresponding TAXUS cohort. In “real world” higher risk ARRIVE pts, the 2-year death rate and cardiac death rate also increased with age while the rates of TLR, MI, and ST actually decreased with age. Elderly pts (age >70) treated with the TAXUS Express2 stent had higher long-term death rates, but comparable TLR and MI rates and reduced ST rates compared to their younger counterparts. Collectively, these results indicate that despite the high-risk clinical and angiographic characteristics commonly observed in elderly pts, this patient population derives similar safety and efficacy from TAXUS stent treatment and such treatment should not be withheld on the basis of age alone when clinically and anatomically appropriate.