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- Title
Are the elderly different?
- Authors
Schröder, J.; Müller-Werdan, U.; Reuter, S.; Vogt, A.; Schlitt, M.; Raaz, U.; Reindl, I.; Buerke, M.; Werdan, K.; Schlitt, A.
- Abstract
Background: The aim of this study was to investigate factors influencing mortality after percutaneous coronary intervention (PCI) in patients aged ≥ 75 years compared to younger patients. Patients and methods: A total of 1,809 coronary heart disease (CHD) patients after PCI with stent implantation in our hospital were assessed. Kaplan-Meier analyses with log-rank test and Cox regression analyses were performed on three predefined models concerning primary endpoint of all-cause mortality. Model 1 was a univariate analysis of the influence of age dichotomized by age 75 years on the primary endpoint. Model 2 included age and classical cardiovascular risk factors (CVRFs, e.g., body mass index (BMI), smoking, diabetes, and hypertension). Model 3 consisted of age, classical CVRFs, and additional factors (e.g., medication; hemoglobin, peripheral arterial disease (PAD), low-density lipoprotein cholesterol (LDL-C) and creatinine levels, and left ventricular ejection fraction (LVEF)). Results: In the mean follow-up of 137 ± 61 weeks 375 patients died. Age ≥ 75 years was significantly related to mortality in all models. In model 3, previous stroke, PAD, diabetes, elevated levels of serum creatinine, and increased LDL-C were related to elevated mortality, higher hemoglobin levels, and LVEF > 50% were associated with decreased mortality in all patients and in patients < 75 years. In patients ≥ 75 years arterial hypertension was associated with poor outcome (hazard ratio (HR) 7.989, p = 0.040), previous antiplatelet therapy showed reduced mortality (HR 0.098, p = 0.039). Conclusion: Although risk factors such as previous stroke, PAD, diabetes, renal insufficiency, and anemia were predictors for death in all patients and patients < 75 years, in the elderly only arterial hypertension increased, whereas treatment with platelet inhibitors decreased mortality.
- Subjects
CORONARY heart disease treatment; SURGICAL stents; KAPLAN-Meier estimator; UNIVARIATE analysis; BODY mass index; DIABETES; GERIATRICS
- Publication
Zeitschrift für Gerontologie und Geriatrie, 2013, Vol 46, Issue 2, p144
- ISSN
0948-6704
- Publication type
Article
- DOI
10.1007/s00391-012-0338-y