Comparative outcomes in elderly patients with multivessel coronary artery disease against the background of various therapy strategies

Abstract

The authors carried out a comparative study of annual outcomes in patients of the older age group who underwent PCI, CABG or were exclusively on optimal drug therapy. A study was carried out, 254 patients over 65 years old with lesions of the left coronary artery in combination with lesions of two or more coronary arteries. All patients received generally accepted basic therapy, which included acetylsalicylic acid (ASA), clopidogrel, beta-blocker bisoprolol 2.5-5 mg / day, ACE inhibitor, rosuvastatin 20 mg/day. According to the chosen treatment strategy, the patients were divided into 3 groups. The first group consisted of patients who underwent stenting of the coronary arteries (from 1 to 4 stents, n = 99), the second - those who underwent coronary bypass grafting (from 2 to 4 bypass grafts, n = 86), the third - who received only drug therapy (n = 69). Results were mixed, with evidence of both harm and benefit. This suggests that: 1) invasive intervention in older patients should be carefully considered in the context of the burden of angina pectoris and background drug therapy, 2) in older patients with multivessel coronary artery disease, coronary revascularization can significantly contribute reducing symptoms and improving quality of life.