Re: A case for palliative percutaneous coronary intervention

The Authors’ reply: We would like to thank Sarah Blake et al1 for their thoughtful and insightful comments. First, we agree that ‘palliative percutaneous coronary intervention (PCI)’ can be a very useful treatment in this elderly patient population. Locally at our institution, via our heart team meeting, we can offer an elderly symptomatic patient with multiple comorbidities PCI, which often fails to achieve complete revascularisation (even with small territories left ischaemic) but offers significant improvement in symptoms and can leave them safer in the presence of left main stem or proximal left anterior descending disease. Unlike the younger population, these patients prioritise symptomatic relief and quality of life (QoL) over prognostic benefit, preferring a quick and immediate return over life years gained. Second, in elderly patients with chest pain treated medically who re-present to the emergency department, a more definitive intervention can certainly help prevent readmissions. However, a...

Source: Heart - May 31, 2017 Category: Cardiology Authors: Cockburn, J., Hildick-Smith, D. J., Trivedi, U., de Belder, A. J. Tags: PostScript Source Type: research