***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Improvement in quality of life is the major motivation for angioplasty in very elderly patients . The alleviation of symptoms with this method is therefore of particular interest . However , little is known about the impact of angioplasty in terms of quality of life in octogenarian patients and what the treatment costs are . METHODS AND RESULTS We prospect ively compared patients aged 80 years or above ( n=34 , 83+/-3 years ) with younger patients ( n=34 , 62+/-8 years ) regarding their quality of life following coronary angioplasty .  Patients were interviewed immediately following angioplasty and 6 months later using the SF-36 health survey . Key determinants of costs and follow-up for 6 months were documented . The number of diseased vessels , interventions performed and number of lesions treated were comparable in both groups . Success rates were lower in the octogenarian than in the control group ( 88 vs 97 % ) . In both groups angioplasty significantly improved the ability to fulfil physical role expectations and decreased bodily pain . Both the effects on Role Physical and on Bodily Pain were more pronounced in the octogenarian patients . Determinants of costs did not differ significantly between the two groups . CONCLUSIONS Our data demonstrate that in octogenarians with symptomatic coronary heart disease , coronary angioplasty significantly increases physical abilities and decreases pain . Further , these effects were more pronounced in octogenarian patients than in younger patients Background — The purpose of this study was to develop a long-term model to predict mortality after percutaneous coronary intervention in both patients with ST-segment elevation myocardial infa rct ion and those with more stable coronary disease . Methods and Results — The American College of Cardiology Foundation CathPCI Registry data were linked to the Centers for Medicare and Medicaid Services 100 % denominator file by probabilistic matching . Preprocedure demographic and clinical variables from the CathPCI Registry were used to predict the probability of death over 3 years as recorded in the Centers for Medicare and Medicaid Services data base . Between 2004 and 2007 , 343 466 patients ( 66 % ) of 518 195 patients aged ≥65 years undergoing first percutaneous coronary intervention in the CathPCI Registry were successfully linked to Centers for Medicare and Medicaid Services data . This study population was r and omly divided into 60 % derivation and 40 % validation cohorts . Median follow-up was 15 months , with mortality of 3.0 % at 30 days and 8.7 % , 13.4 % , and 18.7 % at 1 , 2 , and 3 years , respectively . Twenty-four characteristics related to demographics , clinical comorbidity , prior history of disease , and indices of disease severity and acuity were identified as being associated with mortality . The C indices in the validation cohorts for patients with and without ST-segment elevation myocardial infa rct ion were 0.79 and 0.78 . The model calibrated well across a wide range of predicted probabilities . Conclusions — On the basis of the large and nationally representative CathPCI Registry , we have developed a model that has excellent discrimination , calibration , and validation to predict survival up to 3 years after percutaneous coronary intervention This study was performed to assess the possibility that patient age may independently affect improvements in health-related quality of life following percutaneous coronary intervention .  One hundred five patients undergoing elective percutaneous coronary intervention at a single tertiary referral center between January 10 , 2001 and January 6 , 2002 were enrolled and prospect ively evaluated . Health-related quality of life was assessed before and 1 year following percutaneous coronary intervention using Short Form-12 and the Seattle Angina Question naire . For the purpose of analysis , patients were divided according to age ( younger than 60 , 60 - 70 , and older than 70 years ) . One hundred patients ( 95 % ) completed both question naires . Baseline characteristics among the age groups were similar in terms of gender , cardiac risk factors , and procedural details . All health-related quality -of-life indices demonstrated improvements with at least four variables in each group achieving a clinical ly significant increase ( > 20 % ) . At least eight modalities in each group achieved statistical significance ( p=0.01 ) . With the exception of physical functioning , the improvements in health-related quality of life were not significantly different among age groups BACKGROUND Selection of the optimum mode of coronary revascularization should not only be directed by technical outcomes , but should also consider patients ' postprocedural health status , including symptoms , functionality , and quality of life . METHODS Health status was analyzed and compared after  percutaneous coronary intervention ( PCI ) and coronary artery bypass grafting ( CABG )  using the Seattle Angina Question naire ( SAQ ) . The SAQ was administered to 475 patients ( 252 PCI and 223 CABG ) preprocedure and then monthly for 6 months and again at 1 year . Differences in baseline characteristics were controlled by multivariable risk adjustment , and outcomes over time were compared using repeated- measures analysis of variance . RESULTS In-hospital , 6- and 12-month clinical outcomes were not different ; however , 25 % of PCI patients required at least one reintervention during the study period , compared with only 1 % of CABG patients ( p < 0.001 ) . Although physical function decreased for CABG patients at 1 month ( p < 0.001 ) , it improved and was better than the PCI group by 12 months ( p = 0.008 ) . Relief of angina was greater for CABG than PCI when analyzed over time ( p < 0.001 ) , principally due to the adverse effects of restenosis in the PCI group . Multivariable analysis confirmed that CABG independently conferred greater angina relief compared with PCI ( p < 0.001 ) . At 12 months postprocedure , quality of life had improved to a greater extent for CABG than PCI ( p = 0.004 ) . CONCLUSIONS Over 12 months of follow-up , health status was improved to a greater extent for CABG patients than for PCI patients , primarily due to the adverse influence of restenosis after PCI Introduction The aim of this study was to prospect ively assess the clinical outcome and quality of life of elderly patients who underwent either coronary artery bypass grafting ( CABG ) or percutaneous coronary intervention ( PCI ) with drug-eluting stents ( DES ) for treatment of significant left main disease ( LMD ) compared to a younger patient population . Methods Consecutive patients , admitted into our institution between 04/2004 and 12/2007 with LMD and a life expectancy of > 1 year were prospect ively included and stratified in two groups ( either CABG or left main stenting [ LMS ] with DES ) based on the patients ’ age at inclusion ( > or ≤75 years ) . Rates of death , myocardial infa rct ion ( MI ) , stroke , and target lesion revascularization ( TLR ) were evaluated over a 12 month follow-up . Six months after the initial procedure , additionally , quality of life was assessed using the SF-36 question naire . Results A total of 300 patients was included ; 56 of the 95 PCI patients ( 59 % ) were ≤75 years and 39 ( 44 % ) > 75 years , whereas 155 of 205 patients in the CABG group were ≤75 years ( 76 % ) , and 50 patients ( 24 % ) were > 75 years . Mean follow-up was 312 ± 226 days in the PCI and 377 ± 286 in the CABG group . Rates of death and MI were not significantly different between the four groups at the end of follow-up . There was no difference in quality of life after 6 months . Conclusion In this prospect i ve trial , PCI of LM with DES in elderly patients was feasible with a short- and intermediate term outcome comparable to CABG procedure and to a younger patient cohort Ischemic heart disease affects more than 25 % of persons older than 65 years of age in the United States . Although elderly patients with coronary artery disease tend to be treated less aggressively than nonelderly patients , the use of percutaneous coronary intervention ( PCI ) in the elderly is increasing rapidly ; it more than doubled between 1979 and 1986 ( 1 ) . Previous studies have examined the risks for PCI-related complications among elderly patients and found that elderly patients have a higher risk for vascular complications and in-hospital death than younger patients ( 2 ) . Nonetheless , little is known about the critical outcomes of these procedures from the patient 's perspective . Although short- and long-term mortality rates are important outcomes to consider , PCI is generally done to improve the patient 's quality of life by relieving the signs and symptoms of myocardial ischemia . Improvement in quality of life may be particularly germane to older patients , for whom competing risks tend to limit any potential gains in longevity ( 3 ) . We examined changes in health-related quality of life among elderly patients after PCI  and compared these changes with those in nonelderly patients . Methods Study Sample Patients in this study had PCI as part of two r and omized multicenter clinical trials : the Balloon versus Optimal Atherectomy Trial ( BOAT ; n = 989 ) , which compared directional atherectomy  with balloon angioplasty ( 4 ) , and the Advanced Cardiovascular System Multi-Link-Stent System Trial ( ASCENT ; n = 1040 ) , which compared the ACS Multi-Link stent to the PalmazSchatz stent ( 5 ) . Only patients enrolled in U.S. hospitals who completed a baseline health-related quality -of-life survey ( n = 1789 ) were eligible for our sub study . Inclusion and exclusion criteria for the trials were similar . All patients had symptomatic coronary artery disease that required percutaneous revascularization of a single native coronary artery . Patients with a myocardial infa rct ion within 5 days of treatment , stroke within the preceding 3 months , bifurcation lesions , or severe proximal tortuosity were excluded . The institutional review boards of each institution approved the studies , and all patients provided informed consent before participation . Quality -of-Life Assessment Health-related quality of life was assessed by using the physical and mental health summary scales of the Medical Outcomes Study Short-Form Survey ( SF-36 ) ( 6 , 7 ) . These summary scales are st and ardized such that the mean ( SD ) for the U.S. population is 50 10 . Higher scores indicate better health .  Patients in ASCENT also completed the Seattle Angina Question naire ( SAQ ) , a vali date d disease-specific instrument that measures five health-related quality -of-life domains specific for coronary artery disease ( physical functioning , anginal stability , anginal frequency , disease perception , and treatment satisfaction ) ( 8 , 9 ) . The SAQ scores range from 0 to 100 , and higher scores indicate better levels of functioning ( that is , less physical limitation and less frequent angina ) . Baseline health-related quality of life was assessed by using self-administered question naires that were completed immediately before the index revascularization procedure . Follow-up measurements were obtained by surveys mailed to participants 6 months and 1 year after initial treatment . Patients who did not respond to the mailed survey within 2 weeks were administered the same instrument by telephone when possible . Statistical Analysis Baseline patient characteristics of elderly ( 70 years of age ) and nonelderly ( < 70 years of age ) patients were compared by using t-tests and Wilcoxon rank-sum tests for continuous variables and Fisher exact tests for categorical variables . Logistic regression was used to determine whether the likelihood of substantial improvement in health-related quality of life after PCI differed between elderly and nonelderly patients ( 10 ) . For each health-related quality -of-life scale , each patient was classified as improved or not improved according to the level of change at which patients in previous studies had reported substantial improvement . Previous studies involving the SF-36 have demonstrated that changes in the physical component score of 3.8 points or more and changes in the mental component score of 7.2 points or more were meaningful to patients ( 6 ) . For the SAQ subscales , an improvement of 10 or more points has been found to correlate with clinical ly meaningful changes ( 9 ) and was used to classify patients as improved or not improved for our analysis . Each regression model adjusted for patient demographic characteristics ( sex , marital status , education , race or ethnicity ) and medical conditions ( previous myocardial infa rct ion , congestive heart failure , diabetes , chronic obstructive pulmonary disease , peripheral vascular disease , arthritis , vision problems , number of comorbid conditions , smoking status ) . St and ardized predicted probabilities derived from these models were used to estimate the percentage of patients in each age group who were expected to demonstrate substantial improvement after PCI . We also calculated st and ardized risk differences and associated confidence intervals ( 11 ) . The main results were not altered in analyses that adjusted for clustering ( data not shown ) . All analyses were done by using Stata software , version 6.0 ( Stata Corp. , College Station , Texas ) . P values less than 0.05 were considered statistically significant . Significance tests were not adjusted for multiple comparisons . All data were collected and analyzed by an independent data coordinating center ( Cardiovascular Data Analysis Center , Boston , Massachusetts ) , without direct input from the study sponsor . Twenty percent of the data were missing because of patient nonresponse at follow-up . To examine whether our results were sensitive to differences between respondents and nonrespondents , we imputed the change scores of nonrespondents by using multiple imputation techniques ( 12 ) and re-estimated the models for the full study sample . Because the results of these sensitivity analyses were similar to our primary results , we report only the primary results . Results Of the patients who completed the baseline survey , 1445 ( 
    Output:
    
Results : Elderly patients have significant improvements in cardiovascular well-being .
Early HRQOL appears improved from baseline , but recovery in physical health may be slower than in younger patients .
HRQOL is comparable to an age-matched general population and younger patients undergoing PCI .
Conservative management is not able to offer the same HRQOL benefits .
Coronary artery bypass graft surgery may be superior to PCI in the very elderly .
Conclusion : HRQOL after PCI in the elderly can improve for at least 1 year across a broad range of health domains , and is comparable to an age-matched general population and younger patients undergoing PCI .