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Carotid artery stenting in clinical practice depending on patient age
Author(s) -
Ledwoch Jakob,
Staubach Stephan,
Segerer Manuela,
Strohm Henning,
Mudra Harald
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27127
Subject(s) - medicine , stroke (engine) , asymptomatic , clinical endpoint , hazard ratio , myocardial infarction , confidence interval , population , stent , carotid stenting , randomized controlled trial , surgery , cardiology , carotid endarterectomy , stenosis , mechanical engineering , environmental health , engineering
Background The age‐dependent outcome of carotid artery stenting (CAS) outside of randomized controlled trials is largely unknown. Therefore, we assessed acute and long‐term results of CAS in a single‐center real‐world registry. Methods All symptomatic and asymptomatic patients who consecutively underwent CAS were enrolled into the present analysis. The population was divided into three groups dependent on patients' age (<65, 65–74, and ≥75 years). Results Between 1999 and 2015, a total of 878 patients (24%, <65 years; 40%, 65–74 years; and 36%, ≥75 years) underwent CAS. The rate of the primary endpoint (30‐day composite of death, stroke, and myocardial infarction [MACCE] plus long‐term ipsilateral stroke) was higher in patients aged ≥75 years compared to the middle‐age group (hazard ratio [HR] 2.30, confidence interval [CI] 1.22–4.36; P = 0.001). Similarly, the rate of the stroke endpoint (30‐day any stroke plus long‐term ipsilateral stroke) was higher in patients aged ≥75 years compared to patients aged 65–74 years (HR 2.03, CI 1.01–4.10; P = 0.04). There was no significant age‐dependent difference of the primary endpoint and stroke endpoint in the subset of asymptomatic patients. Furthermore, age had no influence on the risk of stroke beyond the periprocedural period. Conclusions Patients aged ≥75 years had poorer outcomes after CAS compared to younger patients. Importantly, age did not influence the outcome in asymptomatic patients and the risk for stroke beyond the periprocedural period.