Korean Circulation Journal

  • 제44권2호
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  • Pages.113-117
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  • 2014
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Unprotected Left Main Percutaneous Coronary Intervention in a 108-Year-Old Patient

  • Rahman, Afzalur (Department of Cardiology, National Institute of Cardiovascular Diseases) ;
  • Islam, A.K.M. Monwarul (Department of Cardiology, National Institute of Cardiovascular Diseases)
  • 투고 : 2013.08.08
  • 심사 : 2013.10.01
  • 발행 : 2014.02.28
⟨ 이전 논문 다음 논문 ⟩

초록

With the increase in life expectancy, the proportion of very elderly people is increasing. Coronary artery disease (CAD) is an important cause of mortality and morbidity in this age group, for which myocardial revascularization is often indicated. Percutaneous coronary intervention (PCI) in the very elderly bears the inherent risks of complications and mortality, but the potential benefits may outweigh these risks. A number of observational studies, registries, and few randomized controlled trials have shown the safety and feasibility of PCI in octogenarians and nonagenarians. However, PCI is only rarely done in centenarians; so, the outcome of percutaneous coronary revascularization in this age group is largely unknown. PCI in a centenarian with complex CAD is described here; the patient presented with unstable angina despite optimum medical therapy, and surgery was declined. Good angiographic success was followed by non-cardiac complications, which were managed with a multidisciplinary approach.

키워드

참고문헌

  1. Office for National Statistics. Statistical bulletin: Estimates of the Very Old (including Centenarians), 2002-2011, England and Wales [Internet]. [Accessed on July 23, 2013]. Available from: http://www.ons.gov.uk/ons/dcp171778_303741.pdf.
  2. United State's Census Bureau. The 2012 Statistical Abstract; Population: Estimates and Projections by Age, Sex, Race/Ethnicity; Resident Population Projections by Race, Hispanic Origin Status, and Age--Projections [Internet]. [Accessed on July 23, 2013]. Available from: http://www.census.gov/compendia/statab/2012/tables/12s0012.pdf.
  3. Gale CP, Cattle BA, Woolston A, et al. Resolving inequalities in care? Reduced mortality in the elderly after acute coronary syndromes. The Myocardial Ischaemia National Audit Project 2003-2010. Eur Heart J 2012;33:630-9. https://doi.org/10.1093/eurheartj/ehr381
  4. Singh M, Peterson ED, Roe MT, et al. Trends in the association between age and in-hospital mortality after percutaneous coronary intervention: National Cardiovascular Data Registry experience. Circ Cardiovasc Interv 2009;2:20-6. https://doi.org/10.1161/CIRCINTERVENTIONS.108.826172
  5. Bauer T, Mollmann H, Weidinger F, et al. Predictors of hospital mortality in the elderly undergoing percutaneous coronary intervention for acute coronary syndromes and stable angina. Int J Cardiol 2011;151:164-9. https://doi.org/10.1016/j.ijcard.2010.05.006
  6. Wang TY, Gutierrez A, Peterson ED. Percutaneous coronary intervention in the elderly. Nat Rev Cardiol 2011;8:79-90. https://doi.org/10.1038/nrcardio.2010.184
  7. McKellar SH, Brown ML, Frye RL, Schaff HV, Sundt TM 3rd. Comparison of coronary revascularization procedures in octogenarians: a systematic review and meta-analysis. Nat Clin Pract Cardiovasc Med 2008;5:738-46. https://doi.org/10.1038/ncpcardio1348
  8. Rana O, Moran R, O'Kane P, et al. Percutaneous coronary intervention in the very elderly ($${\geq}$$85 years): trends and outcomes. Br J Cardiol 2013;20:27-31.
  9. Rathod K, Knight C. Percutaneous coronary intervention in old age - effective or intrusive? Br J Cardiol 2013;20:6-7.
  10. King SB 3rd, Marshall JJ, Tummala PE. Revascularization for coronary artery disease: stents versus bypass surgery. Annu Rev Med 2010;61:199-213. https://doi.org/10.1146/annurev.med.032309.063039
  11. Sheridan BC, Stearns SC, Rossi JS, D'Arcy LP, Federspiel JJ, Carey TS. Three-year outcomes of multivessel revascularization in very elderly acute coronary syndrome patients. Ann Thorac Surg 2010;89:1889-94; discussion 1894-5. https://doi.org/10.1016/j.athoracsur.2010.03.003
  12. Hlatky MA, Boothroyd DB, Bravata DM, et al. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. Lancet 2009;373:1190-7. https://doi.org/10.1016/S0140-6736(09)60552-3
  13. Alam M, Virani SS, Shahzad SA, et al. Comparison by meta-analysis of percutaneous coronary intervention versus coronary artery bypass grafting in patients with a mean age of $${\geq}$$70 years. Am J Cardiol 2013;112:615-22. https://doi.org/10.1016/j.amjcard.2013.04.034
  14. Kaehler J, Meinertz T, Hamm CW. Coronary interventions in the elderly. Heart 2006;92:1167-71. https://doi.org/10.1136/hrt.2005.071266
  15. Fajadet J, Chieffo A. Current management of left main coronary artery disease. Eur Heart J 2012;33:36-50b. https://doi.org/10.1093/eurheartj/ehr426
  16. Dash D. Stenting of left main coronary artery stenosis: A to Z. Heart Asia 2013;5:18-27. https://doi.org/10.1136/heartasia-2012-010218
  17. Capodanno D, Stone GW, Morice MC, Bass TA, Tamburino C. Percutaneous coronary intervention versus coronary artery bypass graft surgery in left main coronary artery disease: a meta-analysis of randomized clinical data. J Am Coll Cardiol 2011;58:1426-32. https://doi.org/10.1016/j.jacc.2011.07.005
  18. Mohr FW, Morice MC, Kappetein AP, et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year followup of the randomised, clinical SYNTAX trial. Lancet 2013;381:629-38. https://doi.org/10.1016/S0140-6736(13)60141-5
  19. Groeneveld PW, Matta MA, Greenhut AP, Yang F. Drug-eluting compared with bare-metal coronary stents among elderly patients. J Am Coll Cardiol 2008 27;51:2017-24.
  20. Douglas PS, Brennan JM, Anstrom KJ, et al. Clinical effectiveness of coronary stents in elderly persons: results from 262,700 Medicare patients in the American College of Cardiology-National Cardiovascular Data Registry. J Am Coll Cardiol 2009;53:1629-41. https://doi.org/10.1016/j.jacc.2009.03.005