Long-term paclitaxel-eluting stent outcomes in elderly patients

Daniel E. Forman, David A. Cox, Stephen G. Ellis, John M. Lasala, John A. Ormiston, Gregg W. Stone, Mark A. Turco, Jeanne Y. Wei, Anita A. Joshi, Keith D. Dawkins, Donald S. Baim

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background-Although drug-eluting stents have become a mainstay of percutaneous coronary intervention, information about drug-eluting stents outcomes in elderly patients is limited. Data from the paclitaxel-eluting stent (PES) trials and registries were pooled to assess PES benefits relative to advancing patient age, including comparison with bare-metal stents. Methods and Results-Data from 5 randomized trials (2271 patients with PES, 1397 patients with bare-metal stents) and from 2 postmarket registries (7492 patients with PES) were pooled separately. Each dataset was stratified into age groups: <60, 60 to 70, and >70 years. At baseline, patients aged >70 years in both datasets had significantly more adverse characteristics than younger patients. Through 5 years, trial data showed that patients aged >70 years had higher death rates, but comparable rates of myocardial infarction, stent thrombosis, and target lesion revascularization with younger patients. Compared with patients with bare-metal stents, patients with PES aged >70 years had comparable rates of death, myocardial infarction, and stent thrombosis but a significantly lower target lesion revascularization rate (22.2 versus 10.2, P<0.001). These findings were echoed in the registry data through 2 years that showed that PES patients aged >70 years had significantly higher death rates, but lower myocardial infarction, stent thrombosis, and target lesion revascularization rates, compared with younger patients. Although the mortality rates of patients aged >70 years were higher than those of younger patients, they were comparable with those of age- and gender-matched norms in the general population. Conclusions-This analysis of almost 10 000 patients demonstrated that percutaneous coronary intervention with PES is a safe and an effective treatment option that should not be withheld based on age.

Original languageEnglish
Pages (from-to)178-187
Number of pages10
JournalCirculation: Cardiovascular Interventions
Issue number3
StatePublished - Jun 2009


  • Aging
  • Coronary disease
  • Paclitaxel-eluting stents
  • Revascularization


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