What is the best medical approach in octogenarian patients with coronary artery disease? A 6-year experience

Aims: Best popular perception that coronary artery bypass grefting in octogenarians carries high risk related primarily to advanced age. Nevertheless, the effects of CABG, percutaneous coronary intervention , and medical treatment were not assessed on life adequately. Material and Methods: In the present study, survival duration of 375 octogenarian patients who underwent coronary angiography (CAG) in our clinic was evaluated retrospectively. Results: Patients were assigned and compare to seven groups as follows: group 1, patients with normal CAG results; group 2, patients with diffuse coronary narrowness who received medical treatment, group 3, patients who underwent PCI, group 4 was the subgroup of patients from group 3 who underwent PCI in the left anterior descending artery only or in combination with their coronary arteries; group 5, patients in critical condition who were unavailable for any intervention because of cardiac function, group 6, patients who underwent CABG; and group 7, patients who declined the recommended CABG and PCI. For each group, the first-year survival rates were respectively: 100%, 95%, 91.2%, 91.8%, 76.1%, 93.0%, 90.82%. After 6 years, the survival rates were respectively: 76.1%, 80.0%, 72.5%, 71.42%, 52.3%, 90.2%, 76.14%. Rates of patients living by years a significant correlation was revealed between group 6 and group 2 and group 3 (p=0.001, p = 0.004). Group 3 was found to have a significant correlation with Group 4 and Group 7 (p=.000). Group 7 was significantly correlated with groups 3 (p = 0.000), 4 (p = 0.000), and 2 (p = 0.007). Conclusion: Especially in octogenarians who had shortness of the expected survival, the surgical advantage of visual anastomotic replacement, and complete vascularization were successed more than PCI.