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Comparative Study
. 2012 Jan 15;109(2):195-201.
doi: 10.1016/j.amjcard.2011.08.028. Epub 2011 Oct 14.

Comparison of three age groups regarding safety and efficacy of drug-eluting stents (from the National Heart, Lung, and Blood Institute Dynamic Registry)

Kevin R Bainey  1 , Faith Selzer, Howard A Cohen, Oscar C Marroquin, Elizabeth M Holper, Michelle M Graham, David O Williams, David P Faxon
Affiliations
Free PMC article
Comparative Study

Comparison of three age groups regarding safety and efficacy of drug-eluting stents (from the National Heart, Lung, and Blood Institute Dynamic Registry)

Kevin R Bainey et al. Am J Cardiol. .
Free PMC article

Abstract

Limited data exist regarding drug-eluting stent (DES) versus bare metal stent (BMS) use in older patients. From the National Heart, Lung, and Blood Institute Dynamic Registry, 5,089 percutaneous coronary intervention (PCI)-treated patients were studied (October 2001 to August 2006). The differences in 1-year safety (death, myocardial infarction, and their composite) and efficacy (target vessel revascularization [TVR] with PCI and repeat revascularization) outcomes were compared between the patients who received DESs versus BMSs within each age group: <65 years (n = 2,680); 65 to 79 years (n = 1,942); ≥80 years (n = 443). No differences were found in the safety outcomes by stent type in any age group at 1 year. Regarding the effectiveness, lower rates of TVR with PCI and repeat revascularization were observed in the DES patients across all age groups. After propensity-adjusted analysis, the risk of TVR with PCI and repeat revascularization favored DES versus BMS with patients <65 years old (7.4% vs 14.6%, hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.32 to 0.60; 12.3% vs and 17.4%, HR 0.65, 95% CI 0.51 to 0.84, respectively), 65 to 79 years old (4.8% vs 9.5%, HR 0.50, 95% CI 0.31 to 0.80; and 7.6% vs 12.3%, HR 0.62, 95% CI 0.44 to 0.88, respectively), and ≥80 years old (4.5% vs 10.4%, HR 0.15, 95% CI 0.05 to 0.44; and 6.0% vs 14.5%, HR 0.18, 95% CI 0.08 to 0.40, respectively). In conclusion, significant reductions in TVR with PCI and repeat revascularization were noted in all 3 age groups without increases in death or myocardial infarction in this large multicenter PCI registry. Our data support the use of DES, regardless of age.

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Figures

Figure 1
Figure 1
Unadjusted kaplan-meier curves for 1 year clinical outcomes according to stent type (drug-eluting versus bare metal) and age tertile
Figure 1
Figure 1
Unadjusted kaplan-meier curves for 1 year clinical outcomes according to stent type (drug-eluting versus bare metal) and age tertile
Figure 1
Figure 1
Unadjusted kaplan-meier curves for 1 year clinical outcomes according to stent type (drug-eluting versus bare metal) and age tertile
Figure 2
Figure 2
Propensity adjusted analysis for 1 year clinical outcomes by stent type (drug-eluting versus bare metal) and age tertile
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