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Prog Cardiovasc Dis. 2014 Sep-Oct;57(2):176-86. doi: 10.1016/j.pcad.2014.07.002. Epub 2014 Jul 7.

Advances in percutaneous coronary interventions for elderly patients.

Author information

1
Saint Mary's Hospital, Mayo Clinic, Rochester, MN 55901, USA.

Abstract

Coronary heart disease (CHD) is one of the leading causes of morbidity and the most common cause of death in older adults. Paradoxically, elderly patients tend to be systematically excluded from randomized-controlled cardiovascular trials, which complicates decision-making in this population. Management of CHD in the elderly is frequently more difficult in virtue of chronic comorbid conditions and aging-intrinsic dynamics. Despite these challenges, the number of elderly and very elderly patients undergoing percutaneous coronary interventions (PCI) is increasing. Elderly patients in many registries and large clinical series exhibit even a greater benefit from interventional procedures than younger patients, but they have a higher rate of overall complications. We present an overview of the current available evidence of PCI in older adults with stable and unstable CHD, including comparisons between drug-eluting and bare-metal stents, transfemoral and transradial access, and methods of revascularization. Adjuvant antiplatelet and antithrombotic therapies are also discussed.

KEYWORDS:

Cardiovascular disease; Coronary artery disease; Elderly patient; Percutaneous coronary intervention

PMID:
25216617
DOI:
10.1016/j.pcad.2014.07.002
[Indexed for MEDLINE]

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