Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry.
OBJECTIVES: 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. BACKGRO...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2011
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| _version_ | 1826271442180767744 |
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| author | Hong, Y Jeong, M Abizaid, A Banning, A Bartorelli, A Dzavik, V Ellis, S Gao, R Holmes, DR Legrand, V Neumann, F Spaulding, C Worthley, S Urban, P |
| author_facet | Hong, Y Jeong, M Abizaid, A Banning, A Bartorelli, A Dzavik, V Ellis, S Gao, R Holmes, DR Legrand, V Neumann, F Spaulding, C Worthley, S Urban, P |
| author_sort | Hong, Y |
| collection | OXFORD |
| description | OBJECTIVES: 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. BACKGROUND: The use of drug-eluting stents in elderly patients may have different features compared with younger patients. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. |
| first_indexed | 2024-03-06T21:56:46Z |
| format | Journal article |
| id | oxford-uuid:4d2a6ecd-c9f5-4449-ad97-716104de2512 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:56:46Z |
| publishDate | 2011 |
| record_format | dspace |
| spelling | oxford-uuid:4d2a6ecd-c9f5-4449-ad97-716104de25122022-03-26T15:53:58ZSirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4d2a6ecd-c9f5-4449-ad97-716104de2512EnglishSymplectic Elements at Oxford2011Hong, YJeong, MAbizaid, ABanning, ABartorelli, ADzavik, VEllis, SGao, RHolmes, DRLegrand, VNeumann, FSpaulding, CWorthley, SUrban, POBJECTIVES: 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. BACKGROUND: The use of drug-eluting stents in elderly patients may have different features compared with younger patients. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. |
| spellingShingle | Hong, Y Jeong, M Abizaid, A Banning, A Bartorelli, A Dzavik, V Ellis, S Gao, R Holmes, DR Legrand, V Neumann, F Spaulding, C Worthley, S Urban, P Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry. |
| title | Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry. |
| title_full | Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry. |
| title_fullStr | Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry. |
| title_full_unstemmed | Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry. |
| title_short | Sirolimus-eluting coronary stents in octogenarians: a 1-year analysis of the worldwide e-SELECT Registry. |
| title_sort | sirolimus eluting coronary stents in octogenarians a 1 year analysis of the worldwide e select registry |
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