Late outcome and quality of life following percutaneous transluminal coronary angioplasty in octogenarians

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Abstract
Limited data are available concerning the long-term survival and quality of life of octogenarians treated with percutaneous transluminal coronary angioplasty (PTCA). We retrospectively compared the results of PTCA in 118 octogenarians to that of 500 younger subjects. Among the octogenarians, long term follow-up was obtained including survival, relief of angina, assessment of quality of life, and capacity for independent living. These results were compared between men and women. The clinical success rate was 93% for the octogenarians and 88% for the younger patients (p = NS). The lesion success rates were 89% and 88% for these groups, respectively. Results of multilesion PTCA and dilatation of coronary occlusions were similar in both age groups. Major complication rates were 5.9% for the elderly and 3.8% for the younger patients (p < 0.008). Hospital mortality was higher among the octogenarians (4.6% vs 0.2%, p < 0. 05). Among long-term octogenarian survivors, < 90% indicated a high level of satisfaction with their quality of life and health status. If needed, 88% would undergo the procedure again. Independent living was possible for 66% of these patients and automobile driving for 55%. Octogenarian men and women had similar baseline clinical characteristics, procedural success, complications, relief of angina, and survival. Women indicated a slightly lower level of satisfaction and capacity for independent living. PTCA can achieve a success rate in octogenarians comparable to that of younger patients but with an increased risk of serious complications. Patient satisfaction remains high and a majority of octogenarians remain physically active and capable of independent living.