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Our country is a super-aged society and this is an unlike any other in the world. We must consider the treatment strategy for their disease enough. In this study, we examined the clinical outcomes of percutaneous coronary intervention (PCI) for very elderly ischemic coronary artery disease patients in Japan.
From October 2014 to October 2015, 143 patients with 196 lesions had been implanted drug-eluting stent for ischemic coronary artery disease in our hospital. The patients were divided into the very elderly patients (VE) group (≥80 year: 37 patients, 50 lesions) and the non-VE group (106 patients, 146 lesions). The groups were compared for lesions characteristics, procedure characteristics, and the incidence of major adverse cardiac events (MACE) at 1 year.
The tortuous lesion (VE group: 45% vs. non-VE group: 22%, P=0.04) and calcified lesion (52% vs. 34%, P=0.03) were significantly higher in the VE group than the non-VE group. Contrast volume (111.6 ± 46.15 ml vs. 89.2 ± 54.67 ml, P=0.03) and radiation dose (1.54 ± 1.61 Gy vs. 0.98 ± 0.45 Gy, P=0.02) were significantly higher in the VE group. But, there were no significant differences in post-minimal lumen diameter, post % diameter stenosis, and the incidence of MACE between the two groups.
As for the very elderly patients, the lesion morphology is complicated, but there was no significant difference in the clinical outcome. It is thought that PCI for the very elderly patient is an allowable treatment strategy in Japan.