Objectives: Our aim was to access clinical effectiveness of percutaneous coronary intervention (PCI) when added to optimal medical therapy (OMT) in older patients with stable coronary artery disease (CAD).
Background: While older patients with CAD are at increased risk for cardiac events compared with younger patients, it is unclear whether PCI may mitigate this risk more effectively than OMT alone or, alternatively, may be associated with more complications.
Methods: We conducted a pre-specified analysis of outcomes in stable CAD patients stratified by age and randomized to PCI+OMT or OMT alone in the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive druG Evaluation) trial.
Results: A total of 1,381 patients (60%) were <65 years of age (mean 56+/-6 years) and 904 patients (40%) were >or=65 years of age (mean 72+/-5 years). Achieved treatment targets for blood pressure, low-density lipoprotein cholesterol, adherence to diet and exercise, and angina-free status did not differ by age or treatment assignment. Among older patients, there was a 2- to 3-fold higher death rate, but similar rates of myocardial infarction, stroke, and major cardiac events compared with younger patients. The addition of PCI to OMT did not improve or worsen clinical outcomes in patients>or=65 years of age during a median 4.6 year follow-up.
Conclusions: These data support adherence to American College of Cardiology/American Heart Association clinical practice guidelines that advocate OMT as an appropriate initial management strategy, regardless of age. (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation [COURAGE]; NCT00007657).
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jacc.2009.07.013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association between geriatric nutritional risk index and adverse outcomes in critical ill patients with chronic obstructive pulmonary disease: a cohort study of 2824 older adults.
BMC Pulm Med
December 2024
School of Nursing, Jinan University, Guangzhou, China.
Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, particularly among the elderly, resulting in high rates of intensive care unit (ICU) admissions. Malnutrition is common in elderly patients and has been associated with poor prognosis in patients with COPD. However, its impact in the ICU setting remains incompletely defined.
View Article and Find Full Text PDFComparison of clinical characteristics and outcomes in candidaemia patients with and without COVID-19: a multicentre retrospective study.
BMC Infect Dis
December 2024
Department of Infectious Disease, Department of Internal Medicine, Chonnam National University Medical School, 42, Jebong Ro, Donggu, Gwangju, 61469, South Korea.
Background: Invasive fungal infections have been reported as complications with significant mortality and morbidity in patients hospitalized with COVID-19. This study aimed to evaluate the clinical characteristics and outcomes of candidaemia patients with COVID-19 and to investigate the association between COVID-19 and mortality in candidaemia patients.
Methods: This retrospective study included candidaemia patients aged 18 years or older admitted to four university-affiliated tertiary hospitals in South Korea between January 1, 2020, and December 31, 2022.
Evaluating the adherent perinephric fat risk score in East Asian populations and its correlation with non-alcoholic fatty liver disease.
Nutr Metab Cardiovasc Dis
November 2024
Department of Urology, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, 364000, China.
Background And Aims: This study evaluated the predictive value of the APF risk score in East Asian patients undergoing open nephrectomy and its correlation with hypertension and NAFLD.
Methods And Results: A retrospective study used the clinical data of 82 patients who underwent ON between January 2010 and December 2022. Per their APF score, patients were categorized into groups A (0-2 points) and B (3-4 points).
Linking structural and functional changes during healthy aging and semantic dementia using multilayer brain network analysis.
Cortex
December 2024
Normandie Univ, UNICAEN, PSL Université Paris, EPHE, Inserm, U1077, CHU de Caen, Centre Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France. Electronic address:
Healthy aging is characterized by frontal and diffuse brain changes, while certain age-related pathologies such as semantic dementia will be associated with more focal brain lesions, particularly in the temporo-parietal regions. These changes in structural integrity could influence functional brain networks. Here we use multilayer brain network analysis on structural (DWI) and functional (fMRI) data in younger and older healthy individuals and patients with semantic dementia.
View Article and Find Full Text PDFChoroid plexus cysts on 7T MRI: Relationship to aging and neurodegenerative diseases.
Alzheimers Dement
December 2024
7T Magnetic Resonance Imaging Translational Medical Center, Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Introduction: The choroid plexus (CP) may play a crucial role in brain degeneration. We aim to assess whether CP cysts (CPCs), defined using ultra-high field magnetic resonance imaging (MRI), relate to aging and neurodegeneration.
Methods: We used multi-sequence 7T MRI to observe CPCs, characterizing their presence and characteristics in healthy younger controls, healthy older controls (OCs), patients with Alzheimer's disease (AD), patients with Parkinson's disease (PD), and patients with uremic encephalopathy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!