Coronary revascularization in the elderly with stable angina

A proportion of elderly with coronary artery disease is rapidly growing. They have more severe coronary artery disease, that’s why derive more benefit from revascularization and have a greater need for it. The elderly is heterogeneous group, but compared to the younger, the choice of the optimal revascularization method is much more complicated among them. In last decades, results has improved dramatically both in surgery and percutaneous coronary intervention (PCI), even in very old persons. Despite the lack of evidence in elderly, it is obvious, that coronary artery bypass surgery (CABG) has a more pronounced effect on long-term survival in price of more strokes, and PCI is less invasive. Age itself is not a criterion for the selection of treatment strategy, but the elderly are often more interested in quality of life and personal independence instead of longevity. This article discusses the factors that influence on the choice of revascularization method in the elderly with stable angina and presenting the complex algorithm for making an individual risk-benefit profile. Light upon features of CABG and PCI in elderly patients is thrown. Emphasis is made on the frailty and non-medical factors, including psychosocial, as an essential things in making decision of what strategy to choose. Good communication with the patients and giving them unbiased information is encouraged.