Long-term outcome of octogenarians with unstable angina treated conservatively

The 1-year survival rate was similar among candidates and non-candidates for cardiac catheterization and is comparable to that reported for PTCA4–9 and CABG.8,10–14 The age of octogenarians inherently limits the capacity of any treatment modality to substantially prolong survival. Accordingly, palliation of symptoms and improvement in quality of life may be more appropriate end points in this age group. It is important therefore that half of the catheterization candidates experienced a recurrent cardiac event during follow-up. Although most elderly patients have coronary anatomy suitable for PTCA or CABG,15 the use of these procedures to prevent recurrent cardiac events would be expected to produce a higher in-hospital mortality and a similar long-term mortality than that observed in the current study. This underscores the need to develop improved means of identifying octogenarians who will have an unsatisfactory outcome with medical therapy, and to define more specific indications for cardiac catheterization and revascularization in this age group.