Long-term clinical outcome of elderly patients with acute coronary syndrome treated with early percutaneous coronary intervention : Insights from the BASE ACS randomized controlled trial Bioactive versus everolimus-eluting stents in elderly patients

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Nammas , W , de Belder , A , Niemela , M , Sia , J , Romppanen , H , Laine , M & Karjalainen , P P 2017 , ' Long-term clinical outcome of elderly patients with acute coronary syndrome treated with early percutaneous coronary intervention : Insights from the BASE ACS randomized controlled trial Bioactive versus everolimus-eluting stents in elderly patients ' , European Journal of Internal Medicine , vol. 37 , pp. 43-48 . https://doi.org/10.1016/j.ejim.2016.07.027

Title: Long-term clinical outcome of elderly patients with acute coronary syndrome treated with early percutaneous coronary intervention : Insights from the BASE ACS randomized controlled trial Bioactive versus everolimus-eluting stents in elderly patients
Author: Nammas, Wail; de Belder, Adam; Niemela, Matti; Sia, Jussi; Romppanen, Hannu; Laine, Mika; Karjalainen, Pasi P.
Contributor: University of Helsinki, Kardiologian yksikkö
Date: 2017-01
Language: eng
Number of pages: 6
Belongs to series: European Journal of Internal Medicine
ISSN: 0953-6205
URI: http://hdl.handle.net/10138/233949
Abstract: Background: The BASE ACS trial demonstrated an outcome of titanium-nitride-oxide-coated bioactive stents (BAS) that was non-inferior to everolimus-eluting stents (EES) in patients presenting with acute coronary syndrome (ACS). We performed a post hoc analysis of elderly versus non-elderly patients from the BASE ACS trial. Methods: We randomized 827 patients (1:1) presenting with ACS to receive either BAS or EES. The primary end-point was major adverse cardiac events (MACE): a composite of cardiac death, non-fatal myocardial infarction (MI), or ischemia-driven target lesion revascularization (TLR). Follow-up was planned at 12 months and yearly thereafter for up to 7 years. Elderly age was defined as >= 65 years. Results: Of the 827 patients enrolled in the BASE ACS trial, 360 (43.5%) were elderly. Mean follow-up duration was 4.2 +/- 1.9 years. MACE was more frequent in elderly versus younger patients (19.7% versus 12.0%, respectively, p = 0.002), probably driven by more frequent cardiac death and non-fatal MI events (5.3% versus 1.5%, and 9.7% versus 4.5%, p = 0.002 and p = 0.003, respectively). The rates of ischemia-driven TLR were comparable (p > 0.05). In propensity score-matched analysis (215 pairs), only cardiac death was more frequent in elderly patients (6% versus 1.4%, respectively, p = 0.01). Diabetes independently predicted both MACE and cardiac death in elderly patients. Conclusions: Elderly patients treated with stent implantation for ACS had worse long-term clinical outcome, compared with younger ones, mainly due to a higher death rate. (C) 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Subject: Elderly
Acute coronary syndrome
Titanium-nitride-oxide-coated stents
Everolimus-eluting stents
ACUTE MYOCARDIAL-INFARCTION
PRIMARY ANGIOPLASTY
CADILLAC TRIAL
FOLLOW-UP
AGE
IMPLANTATION
MORTALITY
PERFUSION
3121 General medicine, internal medicine and other clinical medicine
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