Sirolimus-eluting coronary stents in octogenarians: A 1-year analysis of the worldwide e-select registry

Young Joon Hong, Myung Ho Jeong, Alexander Abizaid, Adrian Banning, Antonio Bartorelli, Vladimir Dzavik, Stephen G. Ellis, Runlin Gao, David Holmes, Victor Legrand, Franz Josef Neumann, Christian Spaulding, Stephen Worthley, Philip Urban

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)982-991
Number of pages10
JournalJACC: Cardiovascular Interventions
Volume4
Issue number9
DOIs
StatePublished - Sep 1 2011

Fingerprint

Sirolimus
Stents
Registries
Comorbidity
Thrombosis
Confidence Intervals
Drug-Eluting Stents
Myocardial Infarction
Hemorrhage
Population

Keywords

  • coronary artery disease
  • hemorrhagic complication
  • octogenarian
  • percutaneous coronary intervention
  • sirolimus-eluting stent
  • stent thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hong, Y. J., Jeong, M. H., Abizaid, A., Banning, A., Bartorelli, A., Dzavik, V., ... Urban, P. (2011). Sirolimus-eluting coronary stents in octogenarians: A 1-year analysis of the worldwide e-select registry. JACC: Cardiovascular Interventions, 4(9), 982-991. https://doi.org/10.1016/j.jcin.2011.06.013

Sirolimus-eluting coronary stents in octogenarians : A 1-year analysis of the worldwide e-select registry. / Hong, Young Joon; Jeong, Myung Ho; Abizaid, Alexander; Banning, Adrian; Bartorelli, Antonio; Dzavik, Vladimir; Ellis, Stephen G.; Gao, Runlin; Holmes, David; Legrand, Victor; Neumann, Franz Josef; Spaulding, Christian; Worthley, Stephen; Urban, Philip.

In: JACC: Cardiovascular Interventions, Vol. 4, No. 9, 01.09.2011, p. 982-991.

Research output: Contribution to journalArticle

Hong, YJ, Jeong, MH, Abizaid, A, Banning, A, Bartorelli, A, Dzavik, V, Ellis, SG, Gao, R, Holmes, D, Legrand, V, Neumann, FJ, Spaulding, C, Worthley, S & Urban, P 2011, 'Sirolimus-eluting coronary stents in octogenarians: A 1-year analysis of the worldwide e-select registry', JACC: Cardiovascular Interventions, vol. 4, no. 9, pp. 982-991. https://doi.org/10.1016/j.jcin.2011.06.013
Hong, Young Joon ; Jeong, Myung Ho ; Abizaid, Alexander ; Banning, Adrian ; Bartorelli, Antonio ; Dzavik, Vladimir ; Ellis, Stephen G. ; Gao, Runlin ; Holmes, David ; Legrand, Victor ; Neumann, Franz Josef ; Spaulding, Christian ; Worthley, Stephen ; Urban, Philip. / Sirolimus-eluting coronary stents in octogenarians : A 1-year analysis of the worldwide e-select registry. In: JACC: Cardiovascular Interventions. 2011 ; Vol. 4, No. 9. pp. 982-991.
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abstract = "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.",
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AU - Jeong, Myung Ho

AU - Abizaid, Alexander

AU - Banning, Adrian

AU - Bartorelli, Antonio

AU - Dzavik, Vladimir

AU - Ellis, Stephen G.

AU - Gao, Runlin

AU - Holmes, David

AU - Legrand, Victor

AU - Neumann, Franz Josef

AU - Spaulding, Christian

AU - Worthley, Stephen

AU - Urban, Philip

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N2 - 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.

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