Survival after coronary revascularization in the elderly
Survival after coronary revascularization in the elderly
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DOI：
10.1161/01.cir.0000016640.99114.3d
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发表时间：
2002-05-21
期刊：
影响因子：
37.8
通讯作者：
Knudtson, ML
中科院分区：
文献类型：
--
作者：
Graham, MM;Ghali, WA;Knudtson, ML
背景-越来越多的老年缺血性心脏病患者接受冠状动脉旁路移植术或经皮冠状动脉介入治疗。然而，关于老年人不良结局的报告引发了对这些策略益处的质疑。我们研究了3个年龄组6000例老年缺血性心脏病患者的处方治疗（CABG、PCI或药物治疗）生存率，并与年轻患者进行比较。15392例>70岁患者。4-CABG的年调整精算生存率。PCL和药物治疗分别为95.0%、93.8%和90.5%。5198例70 ~ 79岁患者的生存率分别为87.3%、83.9%和79.1%。在983例年龄大于或等于80岁的患者中，CABG组的生存率为77.4%，PCI组为71.6%，药物治疗组为60.3%。年龄大于或等于80岁的患者与药物治疗相比，CABG（17.0%）和PCI（11.3%）的绝对风险差异大于年轻患者。这些结果与最近的随机试验相结合表明，积极的血运重建治疗的益处可能会扩展到老年患者的亚组。
Background-Elderly patients with ischemic heart disease are increasingly referred for coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). However, reports of poor outcomes in the elderly have led to questions about the benefit of these strategies. We studied survival by prescribed treatment (CABG, PCI, or medical therapy) for patients in 3 age categories 6000 elderly patients with ischemic heart disease were compared with younger patients. In 15 392 patients >70 wars of age. 4-year adjusted actuarial survival rates for CABG. PCL and medical therapy were 95.0%, 93.8% and 90.5% respectivly. In 5198 patients 70 to 79 years of age survival rates were 87.3%, 83.9% and 79.1% respectively. In 983 patients greater than or equal to80 years of age, survival was 77.4% for CABG, 71.6% for PCI, and 60.3% for medical therapy. Absolute risk differences in comparison to medical therapy for CABG (17.0%) and PCI (11.3%) were greater for patients greater than or equal to80 years of age than for younger Patients.Conclusions-Elderly patient,, paradoxically have greater absolute risk reductions Associated with surgical Or percutaneous revascularization than do younger patient,.,, The combination of these results with a recent randomized trial suggests that the benefits of aggressive revascularization therapies may extend to subset, Of patients in older age groups.