Acute and long-term results of coronary stents and atherectomy in women and the elderly

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Abstract
To determine the efficacy of new coronary interventions in women and the elderly. We studied 504 patients who underwent a total of 567 procedures, comprising 275 directional coronary atherectomy and 292 Palmaz-Schatz stents over a 2 1/2 year period; 18% were women and 23% were aged ≥70 years (elderly). High rates of success were obtained with these procedures in women and the elderly, although the rates were lower in women than in men (89 versus 96%, P= 0.005), and similarly lower in the elderly than in younger patients (91 versus 96%, P=0.06). In addition to the lower success rates, there was a higher incidence of procedure-related non-Q myocardial infarction and vascular complications in both the women and the elderly, independently. The degree of angiographie restenosis (≥50% diameter stenosis), however, was similar in women (36 versus 28% in men, P= 0.22) and in the elderly (28 versus 29% in patients ages Conclusion Both directional coronary atherectomy and coronary stenting can be performed safely and effectively in women and the elderly with good long-term clinical results, despite a somewhat lower rate of success and similarly higher rates of acute complications.

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