In a provocative study presented at the annual Scientific Sessions of the American Heart Association in New Orleans, researchers from the Florida Heart Research Institute (FHRI) reported on the excellent long-term results from surgical treatment of coronary artery disease in the very elderly. In an exhaustive 18-year follow-up of over 1,000 patients aged 80 and older who underwent coronary artery bypass surgery here in Miami, this study found that both survival and quality of life were equivalent to that for an age-matched population without heart disease.
Octogenarians represent the fastest growing segment of our population. Nearly 40% of this elderly group suffers from cardiovascular disease and over half will die from it. “Although it is well known that surgery can be performed in this elderly population,” comments Dr. Paul Kurlansky, Director of Research at the Florida Heart Research Institute, “what was previously unclear is whether the long-term results warrant the increased risk and expense of surgery in this high risk population.” Dr. Kurlansky and colleagues at the Institute analyzed the operative results and long-term outcomes, including a standardized assessment by each patient of his perception of his health status. The findings were extremely encouraging: 1) hospital mortality from the surgery plummeted over the decade studied from 15% to 2.2%, comparable to what is found for younger patients; 2) long-term survival is equivalent to that for the age-matched population; 3) need for subsequent procedures is minimal; and 4) patient perception of quality of life is equivalent to that for the general population. At a time when the elderly population is growing, the range of potential therapies is increasing, and the health care dollar is becoming increasingly scarce, this landmark study provides critical information regarding the outcome of surgical intervention. “The finding that patients not only survive but continue to lead meaningful quality lives with minimal need for further intervention is what distinguishes this work,” noted Kathleen DuCasse, CEO of the Research Institute.
