Key result
Coronary stenting without intravascular ultrasound in patients aged ≥70 years yielded an event-free survival rate of 83.9% at an average follow-up of 8.6 months.
Why the study?
Does high-pressure intracoronary stenting without intravascular ultrasound and routine warfarin yield acceptable event-free survival in elderly patients?
Observational (n=87)
Does high-pressure intracoronary stenting without intravascular ultrasound and routine warfarin yield acceptable event-free survival in elderly patients?
High-pressure coronary stenting without intravascular ultrasound and routine warfarin is feasible in elderly patients, yielding an 83.9% event-free survival rate at 8.6 months.
Answers are grounded in this paper and cite their sources.
Supports feasibility of high-pressure stenting without IVUS in elderly patients; hypothesis-generating and requires randomized confirmation before practice change.
One hundred-twelve intracoronary stents (83 Palmaz-Schatz, 25 biliary, and 4 Gianturco-Roubin) were placed in 87 (51.7% male) patients aged > or = 70 years (70-93; mean 76.1) during a 1-year period. All stents were deployed using high-pressure inflation (mean 17.4 +/- 2 atm) without intravascular ultrasound. All patients received antiplatelet therapy with aspirin and ticlopidine. Seven patients additionally received warfarin at the physician's discretion. No patient was excluded from analysis regardless of presentation (40% acute myocardial infarction and 12.6% bailout) or complication. There were four deaths and two target vessel reinterventions in-hospital. One reintervention (a bailout) developed a non-Q-wave myocardial infarction. Bleeding, vascular complications, and length of stay were all greater for the warfarin group. The event-free survival rate was 83.9%, at an average of 8.6 months follow-up. A wide range of elderly patients can thus undergo stenting without intravascular ultrasound, usually without warfarin, yielding results comparable to those with more standard therapy in select populations.
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Bage et al. (1998) conducted an observational in Coronary artery disease requiring stenting (n=87). Coronary stenting without intravascular ultrasound was evaluated on Event-free survival. Coronary stenting without intravascular ultrasound in patients aged ≥70 years yielded an event-free survival rate of 83.9% at an average follow-up of 8.6 months.
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