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Clinical profile and outcome of elderly patients undergoing transcutaneous catheter therapy: A multi-center retrospective study.

Author

Reynaldo Fajardo,
Hazel Penafiel,
Ronald E. Cuyco,
Agapito Fortuno,
Ivan Panganiban

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Publication Information

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Journal of Cardiology
Frequency
Quarterly
Publication Date
July-September 2005
Volume
33
Issue
3
Page(s)
126-132

Abstract

BACKGROUND: This study aims to determine the clinical profile and outcome of elderly Filipino patients with CAD following TCT and to review the factors that will affect their outcome and survival. METHODS: This is a multicenter retrospective cohort study involving elderly Filipino patients (>65 y/o) with CAD who underwent TCT from January 1997 to July 2002. There were 338 elderly patients who were included in the study from the four participating tertiary hospitals in Metro Manila. One hundred eighty-six of them were followed-up for the 6 and 12-month clinical outcomes. RESULTS: Hypertension (71.5 percent), diabetes mellitus (39.6 percent) and smoking (37.5 percent) were the common cardiovascular risk factors noted among patients, and male was the predominant gender (64.4 percent; P=NS). Single and two-vessel involvements were the primary lesions (P=NS). The overall success rate was 96.5 percent with a reported complete revascularization of 69.3 percent (P=0.004). Common immediate procedural complications were renal failure (4.4 percent; P0.021) and significant bleeding (2.9 percent; P0.050). Occurrence of complications were related to: increased number of diseased vessels (P=0.000), cardiogenic shock and high-risk NSTEMI on presentation (P=0.001; P=0.001), dyslipidemnia (P=0.003), renal dysfunction (P=0.000). In-hospital mortality rate was 5.3 percent (P=0.384). Eight of the eighteen mortalities were cardiac in etiology. Overall cumulative survival rate was 0.957 at 6 months and 0.935 at 12 months. Event-free survival curves for myocardial reinfarction, recurrent angina, repeat revascularzation and left ventricular dysfunction were excellent (>0.85) both at 6 month and 12 months follow-ups. CONCLUSION: TCT is generally a safe procedure among elderly Filipino patients with high success rate and minimal complications, as well as excellent short and long-term clinical outcomes. Effect of drug-eluting stents cannot be assessed due to scarcity of cases in the study.

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