Percutaneous coronary intervention in elderly patients: is it beneficial?

Abstract

Persons aged 65 years or older, often referred to as the elderly, are a rapidly increasing population in the United States. Cardiovascular disease is the most common cause of morbidity and death in this age group, and acute coronary syndrome accounts for a significant proportion of the deaths. Percutaneous coronary intervention is a well-established treatment for acute coronary syndrome and symptomatic coronary artery disease. However, community studies have shown that elderly patients are less likely to undergo revascularization, perhaps due to a "treatment-risk" paradox: elderly patients-at higher risk of morbidity and death from acute coronary syndrome-are denied revascularization even though they are likely to benefit from it. Age alone is one of the many reasons why percutaneous coronary intervention is avoided in elderly patients. This review examines past clinical trials and the existing evidence that supports performing percutaneous coronary intervention in elderly patients.

Keywords: Age factors; angina, unstable/complications/prevention & control/therapy; attitude of health personnel; cardiovascular diseases/complications/mortality/prevention & control/therapy; health services for the aged/standards; heart catheterization/utilization; myocardial revascularization/utilization; randomized controlled trials as topic/statistics & numerical data; risk factors; survival analysis; treatment outcome.