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European Heart Journal Advance Access originally published online on December 11, 2006
European Heart Journal 2007 28(3):370-375; doi:10.1093/eurheartj/ehl421
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Carotid artery stenting in octogenarians: results from the ALKK Carotid Artery Stent (CAS) Registry

Ralf Zahn1,*, Thomas Ischinger2, Matthias Hochadel3, Uwe Zeymer3, Wolfgang Schmalz4, Norbert Treese5,{dagger}, Karl Eugen Hauptmann6, Hubert Seggewiß7, Ilse Janicke8, Hartwig Haase9, Harald Mudra10, Jochen Senges for the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)3

1 Städtisches Klinikum, Med. Klinik 8, Kardiologie/Angiologie/Internistische Intensivmedizin, Klinikum Nürnberg, Süd Breslauer Straße 201, 90471 Nürnberg, Germany
2 Städtisches Klinikum, Kardiologie, München-Bogenhausen, Germany
3 Herzzentrum, Kardiologie, Ludwigshafen, Germany
4 Stadtkrankenhaus, Kardiologie, Worms, Germany
5 Marienhospital, Kardiologie, Osnabrück, Germany
6 Krankenhaus der Barmherzigen Brüder, Kardiologie, Trier, Germany
7 Klinikum Schweinfurt, Kardiologie, Schweinfurt, Germany
8 Herzzentrum, Kardiologie, Duisburg, Germany
9 Herz Jesu Krankenhaus, Kardiologie, Dernbach, Germany
10 Städtisches Klinikum, München-Neu-Perlach, Germany

Received 5 October 2006; revised 26 October 2006; accepted 10 November 2006; online publish-ahead-of-print 11 December 2006.

* Corresponding author. Tel: +49 911 398 2989; fax: +49 911 398 2988. E-mail address: erzahn{at}aol.com

See page 276 for the editorial comment on this article (doi:10.1093/eurheartj/ehl498)

Aims We tried to determine the influence of age on complication rates of carotid artery stenting (CAS).

Methods and results Two thousand seven hundred eighty CAS procedures were included in the registry. Median age of the patients was 70.8 years, with a proportion of octogenarians of 11.2% and a significant increase between 1996 (5.9%) and 2005 (13.7%; P for trend = 0.002). In octogenarians, a symptomatic stenosis was a more frequent indication for CAS (60.7% vs. 48%, P < 0.001), the CAS procedure was aborted more frequently (6.9% vs. 2.2%; P < 0.001) and the duration of intervention was longer (Median 45 vs. 40 min; P = 0.008). Increasing age was associated with a significant increase in the in-hospital death or stroke rate (P for trend: 0.001). In-hospital death or stroke rate was also higher in octogenarians compared with younger patients (5.5 vs. 3.2%; P = 0.032, OR = 1.79; 95%CI: 1.04–3.06). Logistic regression analysis showed that age analysed as a continuous variable was a strong predictor of in-hospital death or stroke (P < 0.001), whereas octogenarians had only a trend towards a higher event rate (P = 0.062).

Conclusion CAS in octogenarians is performed in an increasing proportion of patients. In-hospital stroke or death rates increase significantly with older age; however, there was no excess complication rate in octogenarians.

Key Words: Carotid artery stenosis • Carotid artery stenting • Angioplasty • Age • Octogenarian


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