Back to Journals » Clinical Interventions in Aging » Volume 11

Immediate results and long-term cardiovascular outcomes of endovascular therapy in octogenarians and nonoctogenarians with peripheral arterial diseases

Authors Huang HL, Jimmy Juang JM, Chou HH, Hsieh CA, Jang SJ, Cheng ST, Ko YL

Received 9 February 2016

Accepted for publication 1 March 2016

Published 4 May 2016 Volume 2016:11 Pages 535—543

DOI https://doi.org/10.2147/CIA.S106119

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Professor Zhi-Ying Wu

Hsuan-Li Huang,1 Jyh-Ming Jimmy Juang,2 Hsin-Hua Chou,1,3 Chien-An Hsieh,1 Shih-Jung Jang,1 Shih-Tsung Cheng,1,3 Yu-Lin Ko1,3

1Division of Cardiology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, 2Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, 3School of Medicine, Tzu Chi University, Hualien, Taiwan

Purpose: To investigate the clinical outcomes of endovascular therapy (EVT) in octogenarians and nonoctogenarians with peripheral arterial disease.
Methods: A retrospective analysis of 511 patients (654 affected legs) who underwent EVT between July 2005 and December 2013 was conducted in a prospectively maintained database. Immediate results and long-term vascular outcomes were analyzed and compared between octogenarians and nonoctogenarians.
Results: Octogenarians were more likely to be female and have atrial fibrillation (AF), whereas nonoctogenarians had higher rates of obesity, claudication, and medical comorbidities. There were no differences in the rates of EVT success, 30-day major adverse vascular events, and 6-month functional improvement between groups. Over the 10-year follow-up period, the rates of 3-year limb salvage, sustained clinical success, freedom from major cerebrovascular and cardiovascular events, and composite vascular events were similar between groups, but the survival rate was better in nonoctogenarians than in octogenarians (73% vs 63%, respectively, P=0.004). In Cox regression analysis, dependence on dialysis and AF were significant predictors of death (odds ratio [OR] 4.44 in dialyzed and 2.83 in AF patients), major cerebrovascular and cardiovascular events (OR 3.49 and 2.45), and composite vascular events (OR 3.14 and 2.25).
Conclusion:
EVT in octogenarians was feasible, without an increased risk of periprocedural complications. The rates of limb salvage, sustained clinical success, and long-term vascular events were comparable between groups. Dialysis dependence and AF are independent predictors for poor prognosis in patients with peripheral arterial disease. However, these observations require further confirmation in larger scale studies.

Keywords: peripheral artery disease, octogenarians, endovascular therapy, cardiovascular outcomes, dialysis, atrial fibrillation

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Clinical assessment tools identify functional deficits in fragility fracture patients

Ames TD, Wee CE, Le KM, Wang TL, Bishop JY, Phieffer LS, Quatman CE

Clinical Interventions in Aging 2016, 11:563-570

Published Date: 5 May 2016

Frailty and quality of life in elderly patients with acute coronary syndrome

Lisiak M, Uchmanowicz I, Wontor R

Clinical Interventions in Aging 2016, 11:553-562

Published Date: 5 May 2016

Correlation between vitamin D levels and apoptosis in geriatric patients infected with hepatitis C virus genotype 4

Gabr SA, Alghadir AH, Allam AA, Ajarem J, Al-Basher G, Abdel-Maksoud MA, Ghfar AA, Aboud A

Clinical Interventions in Aging 2016, 11:523-533

Published Date: 4 May 2016

Concordance between two methods in measuring treatment adherence in patients with type 2 diabetes

López-Simarro F, Brotons C, Moral I, Aguado-Jodar A, Cols-Sagarra C, Miravet-Jiménez S

Patient Preference and Adherence 2016, 10:743-750

Published Date: 4 May 2016

Treatment adherence to disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis

Xia Y, Yin R, Fu T, Zhang L, Zhang Q, Guo G, Li L, Gu Z

Patient Preference and Adherence 2016, 10:735-742

Published Date: 4 May 2016