TCT@ACC-i2: The Interventional Learning Pathway A1869 JACC April 1, 2014 Volume 63, Issue 12 ANALYSIS OF EFFICACY AND SAFETY OF DRUG ELUTING STENTS IN OCTOGENARIANS AND NONAGENARIANS UNDERGOING PERCUTANEOUS CORONARY INTERVENTIONS Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m. Session Title: Complexities and Complications Abstract Category: 38. TCT@ACC-i2: Complex Patients/Comorbidities Presentation Number: 2108-307 Authors: Maninder Singh, Abhishek Mishra, Mayanka Kamboj, Dwight Stapleton, Edo Kaluski, Guthrie Clinic/Robert Packer Hospital, Sayre, PA, USA Background: Although elderly patients are at a higher risk for coronary artery disease, these patients are under-represented in landmark clinical trials. The aim of this study was to evaluate the long term efﬁcacy and safety of drug eluting stents (DES) compared to bare metal stents (BMS) in octogenarians and nonagenarians undergoing coronary stenting. Methods: In a single center prospective observational registry, 516 octogenarians and nonagenarians underwent successful coronary stenting from ‘01-’12. Post procedural outcomes [all-cause mortality, major adverse cardioascular events (MACE) and bleeding events] were compared between those receiving DES and BMS groups. Results: Mean follow-up duration was 3.3±2 years. Mean age was 83 ± 3yrs and 84 ± 3yrs for DES and BMS respectively. After adjusting by multivariate analysis for differences in baseline, clinical and angiographic characteristics, DES use was an independent predictor of lower target vascular revascularization (TVR) (7% versus 11%, adjusted odds ratio (OR)=0.45, 95% CI=0.23-0.89, p=0.021), lower MACE (37% versus 51%, adjusted OR=0.61, 95% CI=0.42-0.90, p=0.013) and a trend towards lower mortality (30% versus 40%, adjusted OR=0.72 95%CI: 0.48-1.083, p=0.112). At 1 year bleeding rates of the two groups were similar. Adjusted outcomes and MACE free survival is shown in Figure 1. Conclusion: When compared to BMS, DES use in octogenarians and nonagenarians is safe and associated with lower TVR and MACE.

ANALYSIS OF EFFICACY AND SAFETY OF DRUG ELUTING STENTS IN OCTOGENARIANS AND NONAGENARIANS UNDERGOING PERCUTANEOUS CORONARY INTERVENTIONS

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Page 1: ANALYSIS OF EFFICACY AND SAFETY OF DRUG ELUTING STENTS IN OCTOGENARIANS AND NONAGENARIANS UNDERGOING PERCUTANEOUS CORONARY INTERVENTIONS

TCT@ACC-i2: The Interventional Learning Pathway

A1869JACC April 1, 2014

Volume 63, Issue 12

AnAlysis of efficAcy AnD sAfety of Drug eluting stents in octogenAriAns AnD nonAgenAriAns unDergoing PercutAneous coronAry interVentions

Poster ContributionsHall CSunday, March 30, 2014, 3:45 p.m.-4:30 p.m.

Session Title: Complexities and ComplicationsAbstract Category: 38. TCT@ACC-i2: Complex Patients/ComorbiditiesPresentation Number: 2108-307

Authors: Maninder Singh, Abhishek Mishra, Mayanka Kamboj, Dwight Stapleton, Edo Kaluski, Guthrie Clinic/Robert Packer Hospital, Sayre, PA, USA

background: Although elderly patients are at a higher risk for coronary artery disease, these patients are under-represented in landmark clinical trials. The aim of this study was to evaluate the long term efficacy and safety of drug eluting stents (DES) compared to bare metal stents (BMS) in octogenarians and nonagenarians undergoing coronary stenting.

Methods: In a single center prospective observational registry, 516 octogenarians and nonagenarians underwent successful coronary stenting from ‘01-’12. Post procedural outcomes [all-cause mortality, major adverse cardioascular events (MACE) and bleeding events] were compared between those receiving DES and BMS groups.

results: Mean follow-up duration was 3.3±2 years. Mean age was 83 ± 3yrs and 84 ± 3yrs for DES and BMS respectively. After adjusting by multivariate analysis for differences in baseline, clinical and angiographic characteristics, DES use was an independent predictor of lower target vascular revascularization (TVR) (7% versus 11%, adjusted odds ratio (OR)=0.45, 95% CI=0.23-0.89, p=0.021), lower MACE (37% versus 51%, adjusted OR=0.61, 95% CI=0.42-0.90, p=0.013) and a trend towards lower mortality (30% versus 40%, adjusted OR=0.72 95%CI: 0.48-1.083, p=0.112). At 1 year bleeding rates of the two groups were similar. Adjusted outcomes and MACE free survival is shown in Figure 1.

conclusion: When compared to BMS, DES use in octogenarians and nonagenarians is safe and associated with lower TVR and MACE.