Elderly to benefit from newer heart stents

Elderly to benefit from newer heart stents
A veteran walks through the lobby at the last reunion for World War Two veterans of the 10th Mountain Division in Denver, Colorado August 2, 2007. (Rick Wilking/Reuters)NEW YORK (Reuters Health) - Stents coated with the drugsirolimus are safe and effective for treating elderly heartpatients with blocked coronary arteries, according to a newreport.
For elderly patients undergoing angioplasty with insertionof stents to prop open their coronary arteries, the risks are2- to 4-fold higher than for younger patients, the authorsexplain in the American Heart Journal.
The so-call sirolimus-eluting stents, which go by the brandname Cypher, have been shown to reduce the chance of arteriesbecoming blocked again, and therefore the need for anotheroperation. However, so far, there has been limited experienceusing the stents in patients older than 75 years.
Dr. Marcus Wiemer from University Bochum, in BadOeynhausen, Germany and colleagues compared outcomes in 954patients older than 75 years with 5801 younger patientsenrolled in the German Cypher Registry.
The team found that the mortality rate in the hospital washigher in the older patients (1.0 percent) than in the youngerpatients (0.3 percent), but there was no significant differencein heart attacks or the need for repeat procedures.
After 6 months, the overall mortality was 3-fold higher inthe elderly group, but both groups showed significantimprovement in symptoms, the report indicates.
The investigators say even between octogenarians andpatients younger than 80 years old, there were no differencesin hospital deaths or major adverse coronary events after 6months.
These results provide "strong evidence thatsirolimus-eluting stent implantation in the elderly and in veryold patients is feasible and ... should be recommended," theauthors conclude.
"A common concern of doctors and patients that the elderlywill have more problems or side effects during or afterinterventions" was not seen in this study, Wiemer told ReutersHealth.
He explained that even these newer stents don't improve theprognosis for people with coronary artery disease, "but we canimprove the symptoms significantly."
Angina caused by coronary disease is not only painful, "itcauses fear of death," he continued. To deny elderly patientstreatment that eases these symptoms is "unethical."
SOURCE: American Heart Journal, October 2007.