ABSTRACT
We identified 1,369 consecutive patients who received glycoprotein IIb/IIIa inhibitors during 1,461 stenting procedures (2,382 lesions); of these, 240 (17.5%) were aged > or =75 years (253 procedures, 430 lesions). Very elderly patients (> or =75 years) had similar in-hospital outcomes but a higher hemorrhagic stroke rate than patients aged <75 years.
Subject(s)
Angioplasty, Balloon, Coronary/adverse effects , Intracranial Hemorrhages/epidemiology , Intracranial Hemorrhages/etiology , Platelet Aggregation Inhibitors/administration & dosage , Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors , Stroke/epidemiology , Age Factors , Aged , Aged, 80 and over , Angioplasty, Balloon, Coronary/methods , Humans , Intracranial Hemorrhages/prevention & control , Middle Aged , Prevalence , Stroke/etiology , Stroke/prevention & controlABSTRACT
Of 1,369 consecutive patients who underwent stent-assisted coronary angioplasty and who were treated with glycoprotein IIb/IIIa inhibitors during these procedures, 17.5% were >or=75 years of age. Compared with patients <75 years old, those >or=75 years of age had similar procedural and in-hospital outcomes but significantly higher rates of hemorrhagic stroke (0.08% vs 1.2%, p <0.001).
Subject(s)
Angioplasty, Balloon, Coronary/adverse effects , Cerebral Hemorrhage/prevention & control , Platelet Glycoprotein GPIIb-IIIa Complex/antagonists & inhibitors , Platelet Glycoprotein GPIIb-IIIa Complex/therapeutic use , Stroke/prevention & control , Age Factors , Aged , Aged, 80 and over , Blood Vessel Prosthesis Implantation/adverse effects , Cerebral Hemorrhage/etiology , Humans , Middle Aged , Outcome Assessment, Health Care , Retrospective Studies , Risk , Stents/adverse effects , Stroke/etiologyABSTRACT
A 21-year-old woman with a history of systemic lupus erythematosus (SLE) presented to the emergency room with a chief complaint of substernal chest pain and palpitations. She had undergone a four-vessel coronary artery bypass graft operation with separate saphenous vein grafts to the left anterior descending (LAD), obtuse marginal (OM) 1 and 2, and distal right coronary arteries (RCA) 8 months prior to admission. The patient underwent angiography of the coronary vessels, which showed severe diffuse disease with a long, 90% narrowing of the vein graft to the LAD and closed vein grafts to OM1 and OM2. The RCA graft showed mild diffuse disease. An intervention was done in which the LAD was stented twice with subsequent TIMI 3 flow. Advances in medical therapy and a better understanding of the disease have contributed to a dramatic improvement in the long-term survival of patients with SLE. However, despite the overall long-term improvement, coronary artery disease remains a major cause of morbidity and mortality with an incidence of approximately nine-fold greater than would be expected for this population.
