Reference : Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwid...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/2268/168406
Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry.
English
Hong, Young Joon [> >]
Jeong, Myung Ho [> >]
Abizaid, Alexander [> >]
Banning, Adrian [> >]
Bartorelli, Antonio [> >]
Dzavik, Vladimir [> >]
Ellis, Stephen G. [> >]
Gao, Runlin [> >]
Holmes, David R. Jr [> >]
Legrand, Victor mailto [Université de Liège - ULiège > Département des sciences cliniques > Cardiologie >]
Neumann, Franz-Josef [> >]
Spaulding, Christian [> >]
Worthley, Stephen [> >]
Urban, Philip [> >]
2011
JACC. Cardiovascular Interventions
4
9
982-91
Yes (verified by ORBi)
International
1936-8798
1876-7605
United States
[en] Age Factors ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary/adverse effects/instrumentation/mortality ; Australia ; Cardiovascular Agents/administration & dosage ; Drug-Eluting Stents ; Europe ; Female ; Fibrinolytic Agents/therapeutic use ; Humans ; Internet ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Myocardial Infarction/etiology ; North America ; Patient Selection ; Platelet Aggregation Inhibitors/therapeutic use ; Product Surveillance, Postmarketing ; Proportional Hazards Models ; Prospective Studies ; Prosthesis Design ; Registries ; Republic of Korea ; Risk Assessment ; Risk Factors ; Sirolimus/administration & dosage ; South America ; Thrombosis/etiology ; Time Factors ; Treatment Outcome
[en] OBJECTIVES: The aim of this study was to identify the worldwide practice of Cypher Select (Cordis Corporation, Bridgewater, New Jersey) or Cypher Select Plus sirolimus-eluting stent (SES) in patients 80 years of age (octogenarian) and to identify clinical outcomes in this patient population. BACKGROUND: The use of drug-eluting stents in elderly patients may have different features compared with younger patients. METHODS: Between 2006 and 2008, 15,147 patients from 320 hospitals in 56 countries were enrolled in a registry. Initial implantation and follow-up outcome information obtained at 1-year follow-up in 675 octogenarian patients were compared with those in 14,472 nonoctogenarian patients. RESULTS: Octogenarians had significantly more comorbidities and had higher Charlson comorbidity index scores (1.5 +/- 1.6 vs. 1.0 +/- 1.3, p < 0.001). Rates of cardiac death (3.3% vs. 0.9%, p < 0.001), myocardial infarction (2.3% vs. 1.9%, p = 0.021), and definite or probable stent thrombosis (2.3% vs. 0.9%, p = 0.0002), and major bleeding (2.0% vs. 0.9%, p = 0.015) were significantly higher in octogenarians at 1 year; however, there was no significant difference in the rate of target lesion revascularization between the 2 groups (3.2% vs. 2.2%, p = 0.12). In octogenarians, a high Charlson comorbidity index was an independent predictor of death and stent thrombosis up to 360 days from the index procedure (hazard ratio: 1.3, 95% confidence interval: 1.1 to 1.5, p < 0.001, and hazard ratio: 1.5, 95% confidence interval: 1.3 to 1.8, p < 0.001, respectively). CONCLUSIONS: Stenting with SES may be an effective therapeutic option in elderly patients, with acceptable rates of complications and a very low rate of repeat revascularization as demonstrated by this e-SELECT (A Multi-Center Post-Market Surveillance Registry) subgroup analysis.
http://hdl.handle.net/2268/168406
10.1016/j.jcin.2011.06.013
Copyright (c) 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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