[Immediate results of coronary angioplasty in elderly patients. Experience at the Gregorio Marañón General Hospital].

In order to assess the results of PTCA in geriatric patients we retrospectively analysed the coronary angiographic findings and the indication, results and major complications (non-fatal myocardial infarction, emergent surgery and death) in 105 consecutive patients aged 65 or more who had PTCA as a part of a whole group of 600 patients. Among the older patients there were more female gender (p less than 0.001), severe angina (Canadian functional class III or IV) (p less than 0.05), unstable angina (p less than 0.05) and multivessel disease (p less than 0.05) in comparison with the younger group (495 patients). There was no significant difference between the two groups in the success rate (78.7% in patients aged 65 or more versus 84.1% in younger patients) or in the complication rate (8.6% versus 7.9%). A tendency was observed toward a higher complication rate (14%) and a lower success rate (72%) in patients aged 70 or more, but without reaching statistical significance. There were two deaths (1.9%). All the patients with a successful PTCA were improved at hospital discharge, including 21 with multivessel disease that underwent "incomplete vascularization" (single vessel PTCA). Thus, PTCA is feasible in selected old patients with severe angina with an incidence of success and of major complications similar to that obtained in younger patients. On the other hand, the complication rate and the in-hospital mortality of PTCA advantageously compares with those reported for coronary bypass surgery. PTCA could be considered as the first therapeutic option in old patients with an adequate coronary anatomy in whom a myocardial revascularization procedure is required.