New-generation drug-eluting coronary stents in octogenarians: Patient-Level Pooled Analysis from the TWENTE I–IV Trials

Abstract Background Patients aged ≥80 years are often treated with new-generation drug-eluting stents (DES), but data from randomized studies are scarce due to underrepresentation in most trials. We assessed 1-year clinical outcome of octogenarians treated with new-generation DES versus younger patients. Methods We pooled patient-level data of 9204 participants in the TWENTE, DUTCH PEERS, BIO-RESORT, and BIONYX (TWENTE I-IV) randomized trials. The main clinical endpoint was target vessel failure (TVF), a composite of cardiac death, target vessel-related myocardial infarction (MI), or clinically indicated target vessel revascularization. Results The 671 octogenarian trial participants had significantly more comorbidities. TVF was higher in octogenarians than in 8533 patients Conclusions Octogenarian participants in four large-scale randomized DES trials had more comorbidities and a higher incidence of the main endpoint TVF. Cardiac mortality was higher in octogenarians, while there was no increase in MI or target vessel revascularization rates. Treatment of octogenarian patients with new-generation DES appears to be safe and effective.