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Type: Journal article
Title: Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the Worldwide e-SELECT Registry
Author: Hong, Y.
Jeong, M.
Abizaid, A.
Banning, A.
Bartorelli, A.
Dzavik, V.
Ellis, S.
Gao, R.
Holmes, D.
Legrand, V.
Neumann, F.
Spaulding, C.
Worthley, S.
Urban, P.
Citation: JACC: Cardiovascular Interventions, 2011; 4(9):982-991
Publisher: Elsevier Inc.
Issue Date: 2011
ISSN: 1936-8798
Statement of
Young Joon Hong, Myung Ho Jeong, Alexander Abizaid, Adrian Banning, Antonio Bartorelli, Vladimir Dzavik, Stephen G. Ellis, Runlin Gao, David R. Holmes, Victor Legrand, Franz-Josef Neumann, Christian Spaulding, Stephen Worthley and Philip Urban
Abstract: <h4>Objectives</h4>The aim of this study was to identify the worldwide practice of Cypher Select (Cordis Corporation, Bridgewater, New Jersey) or Cypher Select Plus sirolimus-eluting stent (SES) in patients 80 years of age (octogenarian) and to identify clinical outcomes in this patient population.<h4>Background</h4>The use of drug-eluting stents in elderly patients may have different features compared with younger patients.<h4>Methods</h4>Between 2006 and 2008, 15,147 patients from 320 hospitals in 56 countries were enrolled in a registry. Initial implantation and follow-up outcome information obtained at 1-year follow-up in 675 octogenarian patients were compared with those in 14,472 nonoctogenarian patients.<h4>Results</h4>Octogenarians had significantly more comorbidities and had higher Charlson comorbidity index scores (1.5 ± 1.6 vs. 1.0 ± 1.3, p < 0.001). Rates of cardiac death (3.3% vs. 0.9%, p < 0.001), myocardial infarction (2.3% vs. 1.9%, p = 0.021), and definite or probable stent thrombosis (2.3% vs. 0.9%, p = 0.0002), and major bleeding (2.0% vs. 0.9%, p = 0.015) were significantly higher in octogenarians at 1 year; however, there was no significant difference in the rate of target lesion revascularization between the 2 groups (3.2% vs. 2.2%, p = 0.12). In octogenarians, a high Charlson comorbidity index was an independent predictor of death and stent thrombosis up to 360 days from the index procedure (hazard ratio: 1.3, 95% confidence interval: 1.1 to 1.5, p < 0.001, and hazard ratio: 1.5, 95% confidence interval: 1.3 to 1.8, p < 0.001, respectively).<h4>Conclusions</h4>Stenting with SES may be an effective therapeutic option in elderly patients, with acceptable rates of complications and a very low rate of repeat revascularization as demonstrated by this e-SELECT (A Multi-Center Post-Market Surveillance Registry) subgroup analysis.
Keywords: e-SELECT Registry Investigators
Myocardial Infarction
Cardiovascular Agents
Fibrinolytic Agents
Platelet Aggregation Inhibitors
Treatment Outcome
Proportional Hazards Models
Risk Assessment
Risk Factors
Prospective Studies
Prosthesis Design
Product Surveillance, Postmarketing
Age Factors
Patient Selection
Time Factors
Aged, 80 and over
Middle Aged
North America
South America
Drug-Eluting Stents
Republic of Korea
Angioplasty, Balloon, Coronary
Kaplan-Meier Estimate
Rights: © 2011 by the American College of Cardiology Foundation
DOI: 10.1016/j.jcin.2011.06.013
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