Age Differences in Long Term Outcomes of Coronary Patients Treated with Drug Eluting Stents at a Tertiary Medical Center

We evaluate differences in outcomes in younger (<65 years) and older (≥65 years) patients for target lesion failure (TLF) at 2-year follow-up in an unselected consecutive series of patients treated with the everolimus- (EES) and paclitaxel-eluting (PES) stents at a tertiary medical center. 348 consecutive patients (younger 150; older 198) stented with the EES and PES were retrospectively analyzed. The primary endpoint was TLF (composite endpoint of cardiac death, non fatal myocardial infarction due to index vessel and target lesion revascularization (TLR)). At 2 years follow up, younger versus older patients had the following outcomes respectively: TLF 27.7% versus 25.5% ( ), TLR 24.8% versus 21.4% ( ), cardiac death 3.4% versus 2.5% ( ) and definite and probable stent thrombosis (2.0% versus 1.0%). Multivariate analysis showed that renal failure (odds ratio: 2.55, ), number of stents per patient (odds ratio: 1.60, ) and younger age (odds ratio: 0.97; ), but not gender, diabetes or type of DES stent (EES versus PES) predicted TLF. We conclude that older age was not a predictor of TLF at 2-year follow-up after adjusting for renal insufficiency, number of stents used per patient, gender, diabetes and type of DES used. 1. Introduction There is a relative paucity of data on clinical outcomes of elderly patients undergoing contemporary percutaneous coronary interventions (PCIs) with drug eluting stents (DESs). Elderly patients have been frequently excluded from randomized clinical trials because of multiple comorbidities making available data on DES difficult to generalize to older patients [1]. Several reports indicated that older age (>65 years old and particularly >75 years old) is an independent predictor of adverse events after percutaneous coronary interventions (PCIs) with higher inhospital vascular complications and cardiac death [2, 3] and higher long term cardiac mortality [4]. Other reports suggested that older age, after adjusting for various clinical and procedural variables, does not appear to independently predict adverse early or late outcomes after PCI [5, 6]. The paclitaxel-eluting stent (PES) Taxus Liberte (Boston Scientific, Natick, MA, USA) and the everolimus-eluting stent (EES) Xience (or Promus) (Abbott Laboratories, Abbott Park, IL, USA) are drug eluting stents (DESs) that showed lower TVR than bare metal stents (BMSs) irrespective of age, although higher mortality and myocardial infarction seem to increase with higher age groups [7]. In this report, we examine our own data for differences between younger (<65 years) and older (≥65