Cardiac Intervention in the Elderly. Cardiac Interventions. Coronary Artery Bypass Grafting (CABG) Percutaneous Transluminal Coronary Angioplasty (PTCA) ± stenting Valve surgery Radio-frequency Ablation Automatic Implantable Cardiac Defibrillators (AICDs). Ischaemic Heart Disease.
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Many trials selective/unrepresentative:
Mortality (in-hospital) 1.3%
Each point = 0.2 – 2 % rise in mortality
Major predictor of mortality
@ 5 years: 10.2 % (CABG) vs. 15.8 % (medical)
@ 10 years: 26.4 % (CABG) vs. 30.5 % (medical)
10 year follow-up:
Follow – up data is over shorter period
Most data is pre - ticlopidine/clopidogrel
Outcomes similar for single vs. multivessel
Influence of ticlopidine
Study from 1980 –1996