medigraphic.com
ISSN 1561-2937 (Print)

2013, Number 3-4

<< Back Next >>

Rev Cubana Cardiol Cir Cardiovasc 2013; 19 (3-4)

Coronary angiography and percutaneus coronary intervention in the elderly

Aroche AR, Ramírez GA, Obregón SÁG, Hernández NM, Aldama PL

Language: Spanish
References: 19
Page: 133-141
PDF size: 422.04 Kb.


ABSTRACT

Objetive: Determine the effectiveness and short term security of the coronary angiography and percutaneos coronary interven-tion in the elderly.
Method: Descriptive retrospective Study with the 5715 patients to whom coronary angiography was made in the CIMEQ, between 1998 and 2009, taking itself as it shows the 1933 greater ones of 60 years. The information obtained from the data base ANGYCOR, considering the characteristics clinical-angiográficas and of the procedure, in-hospital complications and success procedures, respecting the ethics of the investigations.
Results: The most frequent diagnosis was the stable angina (43.5%). The age average of 65.99 ± 5.06 years, the group of 60 to 69 years was the most frequent, like the masculine sex (77.2%) and the arterial hypertension (64.9%). The 7.8% of the patients had a previous revascularizacion. In the 28.6% of him the coronary intervention was made, in 66.7% on a single coronary artery. The treatment of multiarterial disease increased in the octogenarians (48%). The anterior descend-ing artery was the most frequently approached (51%). The 71.0% of the lesion were complex. In the 81.5% of the treated arteries at least one stent was implanted. In 98.0% the procedure was successful, more than half of the failures it was by guide non-passage. Were reported serious complications only in the 1.4%, including two died (0.4%), both related to diagnosis of the acute coronary syndrome.
Conclusions: The index of complications and mortality in coronary angiography and percutaneus coronary intervention of the elderly are low, with high percentage of success, reason why they seem effective and safe procedures.


REFERENCES

  1. Martínez FAJ, Fernández DIE. Ancianos y salud. Rev Cubana Med Gen Integr 2008; 24(4): Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0 864-21252008000400010&lng=es.

  2. Organización de Naciones Unidas. Informe de la Segunda Asamblea Mundial sobre el Envejecimiento. Publicación de las Naciones Unidas. Nueva York, 2002;197(9).p.2-8.

  3. Organización de Naciones Unidas. Informe de la reunión de gobiernos y expertos sobre envejecimiento en países de América del Sur. Publicación de Naciones Unidas. Buenos Aires, 2006; 292: 2-13.

  4. Oficina Nacional de Estadísticas de Cuba. El Envejecimiento de la Población. Cuba y sus territorios. Disponible en: http://www.one.cu/publicaciones/cepde/envejecimiento/e nvejecimiento2009.pdf.

  5. Ministerio de Salud Pública. Dirección Nacional de Registros Médicos y Estadísticas de Salud. 10 Primeras causas de muerte por grupo de edad y sexo en el adulto mayor. Cuba 2009. Disponible en: http://files.sld.cu/dne/files/2010/06/diez-primerascausas- adulto-mayor-2009.pdf

  6. Martínez-Sellés M, López-Palop R, Datino T, Bañuelos C. Actualización en cardiología geriátrica. Rev Esp Cardiol. 2009;62(Supl 1):53-66.

  7. Bermejo GJ, López DS, López-Sendon JL, Pabón OP, García-Morán E, Bethencourt A, et al. Unstable angina in the elderly: clinical, profile, management and mortality at three months. The PEPA Registry Data. Rev Esp Cardiol. 2000;53:1564-72.

  8. Pfisterer M, Buser P, Osswald S, Allemann U, Amann W, Angehrn W, et al. Outcome of elderly patients with chronic symptomatic coronary artery disease with an invasive vs optimized medical treatment strategy: one-year results of the randomized TIME trial. JAMA. 2003;289:1117-23.

  9. García-Pinilla JM, Jiménez-Navarro MF, Gómez DJJ, Alonso JH, Hernández J M G, Galván ET, et al. Actitud terapéutica tras la coronariografía en pacientes ancianos con cardiopatía isquémica. Rev Clin Esp. 2005;205:595- 600.

  10. Graham MM, Ghali WA, Faris PD, Galbraith PD, Norris CM, Knudtson ML. Survival after coronary revascularization in the elderly. Circulation. 2002;105:2378-84.

  11. The TIME Investigators. Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary-artery disease (TIME): a randomised trial. Lancet 2001;358:951–7.

  12. Bo X, Jian-junL, Yue-jin Y, Ji-lin CH, Shu-bin Q, Xuewen Q, et al. Age-based clinical and angiographic outcomes after sirolimus-eluting stent implantation in patients with coronary artery disease. Chin Med J 2007; 120 (6):447-451.

  13. De Gregorio J, Kobayashi Y, Albiero R, Reimers B, Di Mario C, Finci L et al. Coronary stenting in the elderly: short term outcome and long term angiographic and clinical follow-up. J Am Coll Cardiol 1998; 32: 577-583.

  14. Elder AT, ShawTRD, Turnbull CM, Starkey IR. Elderly and younger patients selected to undergo coronary angiography. BMJ 1991; 303:950-3.

  15. Valente S, Lazzeri Ch, Salvadori S, Chiostri M, Giglioli C, Poli S, et al. Effectiveness and Safety of Routine Primary Angioplasty in Patients Aged ≥85 Years With Acute Myocardial Infarction. Circ J 2008; 72: 67–70.

  16. Merchant MF, Weiner BR, Rao SR, Lawrence R, Healy JL, Pomerantsev E. In-hospital outcomes of emergent and elective percutaneous coronary intervention in octogenarians. Coronary Artery Disease 2009, 20:118–123.

  17. Torre de la HJM, Fernández-Vallsa M, Royuela N, Gonzáleza, Susana G Enríquez GI, Zueco J. Angina inestable en el paciente octogenario: ¿es factible y eficaz el abordaje invasivo? Rev Esp Cardiol. 2001;54:679-84.

  18. Koutouzis M, Grip L, Matejka G, Albertsson P. Primary Percutaneous Coronary Interventions in Nonagenarians. Clin Cardiol 2010;33(3): 157–161.

  19. Aroche AR, Obregón AS, Conde CH, Hernández NM. Stent Liberadores de Fármacos versus stents metálico convencional seguimiento a largo plazo. Revista Investigaciones Médico Quirúrgicas 2007; 2(10):19-25.




2020     |     www.medigraphic.com