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Scientific letters
Percutaneous coronary intervention in octogenarians with refractory angina
  1. J D Ferguson1,
  2. W P Orr1,
  3. C J McKenna1,
  4. D J Blackman1,
  5. K M Channon2,
  6. J C Forfar1,
  7. O Ormerod1,
  8. A P Banning1
  1. 1Department of Cardiology, John Radcliffe Hospital, Oxford, UK
  2. 2Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to:
    Dr Adrian P Banning, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK;
    adrian.banning{at}orh.anglox.nhs.uk

https://doi.org/10.1136/heart.88.1.85

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    Very elderly patients are excluded from most trials of percutaneous coronary intervention (PCI).1,2 There is little contemporary data to guide clinical decision making, particularly in elderly patients presenting with acute coronary syndromes. We have analysed the procedural outcomes of patients 80 years or older undergoing PCI in our centre.

    METHODS

    All patients over 80 years of age undergoing PCI between January 1996 and December 1999 were identified from the catheterisation laboratory computer database. Baseline clinical characteristics, indications for coronary intervention, and procedural outcomes were obtained by retrospective review of hospital records.

    All patients received a heparin bolus (5000–10 000 IU), administration of abciximab was at the operators' discretion, and postprocedural heparin was not used routinely. Routine antiplatelet treatment included long term aspirin, and ticlopidine or clopidogrel for four weeks, usually with preloading.

    Lesions were classified according to the American College of Cardiology/American Heart Association grading system. Immediate angiographic success was defined as deployment of the stent at the site of the lesion with a residual stenosis < 30%. Clinical success was defined as angiographic success plus the absence of major adverse cardiac events (MACE) while in hospital for the index PCI—that is, myocardial infarction, the need for repeat revascularisation, coronary artery bypass grafting (CABG), or …

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