Even those over 80 benefit from angioplasty

Researchers from Lady Davis Carmel Medical Center in Haifa, Israel have shown that patients over the age of 80 who suffer an acute coronary syndrome (ACS) can obtain just as much benefit from angioplasty as the 70-80 year-old patients.

This study, by David Halon and colleagues was published in the Journal of the American College of Cardiology, and was designed to investigate whether there is much benefit in invasive interventions such as angioplasty in the more elderly patients. Angioplasty is not limited to patients under the age of 80, however, there are differing viewpoints on whether it is of much benefit in the more senior group of patients. David Halon and his colleagues appreciated the fact that the elderly population are comprising an increasingly larger proportion of the population, and more research is needed to show their benefit from such procedures.The team included 449 consecutive patients overall, of whom 251 were aged 70 to 79 years, and 198 were aged 80 or older.The results of the study showed, that despite the more elderly set of patients being sicker on admission and more likely to die than those who were 70-79 years old, interventions chosen for individuals aged 80 and over resulted in similar 2-year outcomes to those seen in younger patients. At hospitalization, the older group were significantly more likely to have acute myocardial infarction, heart failure, and renal dysfunction. Rates for revascularisation procedure were similar between the groups. The team reported that patients over the age of 80 were less likely to survive over the following 2 years compared with those younger, at 67.4% versus 83.5% (p<0.0001), this is expected given the age difference. The other outcome criteria analysed were the rates of rehospitalisation, and the satisfaction with the procedure. Repeat rehospitalization was similar between the groups, and improvement in the well-being of survivors was greater among those aged over 80 years. Halon et al concluded elderly patients should be considered individually when being considered for a procedure such as angioplasty, and age on its own should not be a factor.J Am Coll Cardiol 2004; 43: 346-352