[Coronary angioplasty in the aged: short and long term efficacy in patients with unstable angina].

Coronary revascularization procedures in elderly patients are associated with an increase of perioperative complications and death in comparison with younger patients. To assess if a conservative coronary angioplasty approach is useful, 54 consecutive patients (pts) with severe unstable angina were retrospectively evaluated. Mean age was 73 years (range 70-82 years). Multivessel coronary disease was present in 26 pts (48%), angina at rest within the last 2 days in 26 (48%) and an episode of myocardial infarction within 2 weeks in 21 (38%). In 51 cases, regardless of the extension of the coronary disease, only the stenosis considered "culprit" of the symptoms, as assessed by angiography and by noninvasive studies, was dilated. The angiographic success rate was 98% (53 of 54 pts). Two pts had procedure--related myocardial infarction. One patient died after emergency bypass surgery for an abrupt left anterior descending artery occlusion. The mean hospital stay was 8 days (range 2-40 days) and in 75% cases was less than 6 days. Follow-up (achieved in 51 pts) ranged from 1 to 40 months (mean 20 months). In 3 pts a second vessel was treated with a new angioplasty 15-30 days after the first procedure due to the persistence of symptoms. During follow-up three pts died (1 death was cardiac). Of the survivors, 35 were asymptomatic in moderate medical regimen, 1 required bypass surgery and 3 were managed with repeat angioplasty. Survival was 95% at 6 months and 90% at 2 years. At six months 86% of pts were event free (80% and 70% at one and two years, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)