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Susan Gold, MD; Warren F. Wong, MD; Irwin J. Schatz, MD; Patricia Lanoie Blanchette, MD, MPH

Arch Intern Med. 1991;151(6):1085-1088.

Abstract
The widespread availability of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty presents important treatment options for the older patient. The findings from a number of surgical series of coronary artery bypass grafting and percutaneous transluminal coronary angioplasty are summarized. Certain trends are evident. Perioperative mortality, cardiovascular morbidity, and other complications, while declining, remain somewhat higher in elderly patients. However, the impact of age alone is slight. In both coronary artery bypass grafting and percutaneous transluminal coronary angioplasty, complications are more closely correlated with the presence of serious concomitant disease. Long-term survival and pain relief after coronary artery bypass grafting are excellent in older patients, and percutaneous transluminal coronary angioplasty may be the treatment of choice in some elderly patients with coronary artery disease. As in younger patients, prolongation of survival should not be the exclusive goal. Rather, a focus on quality of life and freedom from dependency should be seriously considered.

(Arch Intern Med. 1991;151:1085-1088)

Author Affiliations
From the Departments of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, and McGill University School of Medicine, and McGill Center on Aging, Montreal, Quebec.

Footnotes
Accepted for publication February 26, 1991.

Reprint requests to Division of Geriatric Medicine, 347 N Kuakini St, HPM 9, Honolulu, HI 96817 (Dr Blanchette).

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