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European Heart Journal 1999 20(24):1791-1798; doi:10.1053/euhj.1999.1752
Copyright © 1999 by the European Society of Cardiology.
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Coronary angioplasty in octogenarians. Quality of life and costs

J. Kählera, M. Lütkea, J. Weckmüllera, R. Köstera, T. Meinertza,f1 and C.W. Hammb

a Department of Cardiology, University Hospital Hamburg, Hamburg, Germany
b Kerckhoff Heart Center, Bad Nauheim, Germany

revised June 7, 1999; accepted June 9, 1999

Abstract

Background Improvement in quality of life is the major motivation for angioplasty in very elderly patients. The alleviation of symptoms with this method is therefore of particular interest. However, little is known about the impact of angioplasty in terms of quality of life in octogenarian patients and what the treatment costs are.

Methods and Results We prospectively compared patients aged 80 years or above (n=34, 83±3 years) with younger patients (n=34, 62±8 years) regarding their quality of life following coronary angioplasty. Patients were interviewed immediately following angioplasty and 6 months later using the SF-36 health survey. Key determinants of costs and follow-up for 6 months were documented. The number of diseased vessels, interventions performed and number of lesions treated were comparable in both groups. Success rates were lower in the octogenarian than in the control group (88 vs 97%). In both groups angioplasty significantly improved the ability to fulfil physical role expectations and decreased bodily pain. Both the effects on Role Physical and on Bodily Pain were more pronounced in the octogenerian patients. Determinants of costs did not differ significantly between the two groups.

Conclusions Our data demonstrate that in octogenarians with symptomatic coronary heart disease, coronary angioplasty significantly increases physical abilities and decreases pain. Further, these effects were more pronounced in octogenarian patients than in younger patients.

Key Words: Coronary angioplasty, angina, octogenarians, quality of life, success rates, costs

f1 Correspondence: Prof. Dr med T. Meinertz, Department of Cardiology, University Hospital Hamburg, Martinistr. 52, 20246 Hamburg, Germany.

References

  1. Jackman JD, Navetta FL, Smith JE. Percutaneous transluminal coronary angioplasty in octogenarians as an effective therapy for angina pectoris. Am J Cardiol. 1991;68:116–119[ISI][Medline]
  2. Thompson RC, Holmes DR, Grill DE, Mock MB, Bailey KR. Changing outcome of angioplasty in the elderly. J Am Coll Cardiol. 1996;27:8–14[Abstract]
  3. Vaitkus PT, Witmer WT, Adele C. Cardiologists' perception of risk of coronary revascularization procedures. J Cardiol. 1997;80:339–341
  4. Morrison DA, Bies RD, Sacks J. Coronary angioplasty for elderly patients with ‘high risk’ unstable angina: short-term outcomes and long-term survival. J Am Coll Cardiol. 1997;29:339–344[Abstract]
  5. ten Berg JM, Voors AA, Suttorp MJ. Long-term results after successful percutaneous transluminal coronary angioplasty in patients over 75 years of age. Am J Cardiol. 1996;77:690–705[CrossRef][ISI][Medline]
  6. Mick MJ, Simpfendorfer C, Arnold AZ, Piedmonte M, Lytle BW. Early and late results of coronary angioplasty and bypass in octogenarians. Am J Cardiol. 1991;68:1316–1320[CrossRef][ISI][Medline]
  7. Iniguez A, Macaya C, Hernandez R. Long-term outcome of coronary angioplasty in elderly patients with post-infarction angina. Eur Heart J. 1994;15:489–494[Abstract/Free Full Text]
  8. Peterson ED, Jollis JG, Bebchuk JD. Changes in mortality after myocardial revascularization in the elderly. Ann Intern Med. 1994;121:919–927[Abstract/Free Full Text]
  9. Reynen K, Kunkel B, Bachmann K, Gansser R, Martus P. PTCA in elderly patients: acute results and long-term follow-up. Eur Heart J. 1993;14:1661–1668[Abstract/Free Full Text]
  10. Laster SB, Rutherford BD, Giorgi LV. Results of direct percutaneous transluminal coronary angioplasty in octogenarians. Am J Cardiol. 1996;77:10–13[CrossRef][ISI][Medline]
  11. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30:473–483[ISI][Medline]
  12. Tarlov AR, Ware JE, Greenfield S, Nelson EC, Perrin E, Zubkoff M. The Medical Outcomes Study: An application of methods for monitoring the results of medical care. J Am Med Assoc. 1989;262:925–930[Abstract]
  13. Brazier JE, Harper R, Jones NMB. Validating the SF-36 health survey questionnaire: new outcomes measure for primary care. Br Med J. 1992;305:160–164[ISI][Medline]
  14. McHorney CA, Ware JE, Lu JFR, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across divers patient groups. Med Care. 1994;32:40–66[ISI][Medline]
  15. Ganz PA, Day R, Ware JE, Redmond C, Ficher B. Base-line quality-of-life assessment in the national surgical adjuvant breast and bowel project breast cancer prevention trial. J Natl Cancer Inst. 1995;87:1372–1382[Abstract/Free Full Text]
  16. Aaronson NK, Acquadro C, Alonso J. International quality of life assessment (IQOLA) project. Qual Life Res. 1992;1:349–351[CrossRef][Medline]
  17. Bullinger M. German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. Soc Sci Med. 1995;41:1359–1366[CrossRef][ISI][Medline]
  18. Eisenberg JM. Clinical economics: a guide to the economic analysis of clinical practices. JAMA. 1989;262:2879–2886[CrossRef][ISI][Medline]
  19. Finkler SA. The distinction between costs and charges. Ann Intern Med. 1982;96:102–109[ISI][Medline]
  20. Ware JE. How to score the SF-36 short-form health survey. Boston: International Resource Center for Health Care Assessment; 1992.
  21. Benson H, McCallie DP. Angina pectoris and the placebo effect. N Engl J Med. 1979;300:1424–1429[ISI][Medline]
  22. Strauss WE, Fortin T, Hartigan P, Folland ED, Parisi AF. A comparison of quality of life scores in patients with angina pectoris after angioplasty compared with after medical therapy. Circulation. 1995;92:1710–1719[Abstract/Free Full Text]
  23. Parisi AF, Strauss WE, McIntyre KM, Sasahara AA. Considerations in evaluating new anti-anginal drugs. Circulation. 1982;65:38–42
  24. Agner E. Epidemiology of coronary heart disease in the elderly patient. Coodley EL. Geriatric heart disease. Littleton: PGS Publishing; 1985. p. 114–126
  25. Cleary PD, Epsten AM, Oster G. Health-related quality of life among patients undergoing percutaneous transluminal coronary angioplasty. Med Care. 1991;29:939–950[CrossRef][ISI][Medline]
  26. Sculpher MJ, Seed P, Henderson RA. Health service costs of coronary angioplasty and coronary artery bypass surgery: the Randomized Intervention Treatment of Angina (RITA) trial. Lancet. 1994;344:927–930[CrossRef][ISI][Medline]
  27. Cohen DJ, Breall JA, Ho KKL. Evaluating the potential cost-effectiveness of stenting as a treatment for symptomatic single-vessel coronary disease. Circulation. 1994;89:1859–1874[Abstract/Free Full Text]
  28. Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the ACCESS study. J Am Coll Cardiol. 1997;29:1269–1275[Abstract]
  29. Hlatky MA. Analysis of costs associated with CABG and PTCA. Ann Thorac Surg. 1996;61:S30–32[CrossRef][ISI][Medline]
  30. Vassilikos VP, Lim R, Kreidieh I. Myocardial revascularization in elderly patients with refractory or unstable angina and advanced coronary disease. Cor Art Dis. 1997;8:705–709

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