Heart procedure results have improved for elderly

Over the last decade, the use of angioplasty and coronary artery bypass grafting to treat elderly heart patients has increased, and outcomes of these procedures have improved.

Those findings come from an analysis of data on more than 200,000 adults who underwent "revascularization" - angioplasty or bypass to restore blood-flow to the heart - and are reported in the American Heart Journal by Dr. Eric D. Peterson of the Duke Clinical Research Institute in Durham, North Carolina, and colleagues.

The researchers found that between 1991 and 1999, the proportion of revascularization patients who were 75 years of age or older rose by 10 percent.

Moreover, "Mortality rates declined significantly in older patients for both (angioplasty) and coronary artery bypass grafting over this decade," the investigators report.

According to the study, the risk of in-hospital death related to revascularization procedures rises by approximately 1 percent per decade of life for angioplasty, and by approximately 2 percent per decade of life for surgical procedures.

"Between the ages of 75 and 85 years, this gradual increase in risks is not prohibitive for considering these procedures as viable treatment options," Peterson and colleagues write. But, they caution, "This rate then exponentially increases beyond the age of 85."

Nonetheless, in weighing the risks, age isn't the only factor. "Risk varies markedly among elderly patients, emphasizing the need for individualized risk assessments," the team points out.

SOURCE: American Heart Journal, September 2004.