Association Between Age and PCI Effectiveness in Stable CAD: Secondary Analysis of ORBITA-2.

Whether the effect is consistent across age groups is unknown.

目前尚不清楚这种疗效是否在不同年龄组中保持一致。

The authors sought to evaluate the interaction between age and symptom and stenosis severity, and the efficacy of PCI on the ORBITA-2 primary and secondary endpoints.

作者试图评估年龄与症状和狭窄严重程度之间的相互作用，以及经皮冠状动脉介入治疗（PCI）对ORBITA-2主要和次要终点的疗效。

Methods

All patients from the primary ORBITA-2 trial contributed data to this post hoc analysis.

所有来自主要ORBITA-2试验的患者都为这次事后分析贡献了数据。

For daily symptoms, a bayesian longitudinal Markov model was constructed.

针对每日症状，构建了一个贝叶斯纵向马尔可夫模型。

For treadmill exercise time, stress echocardiography, and questionnaires, a bayesian ordinal proportional odds model was used, including the prerandomization value and treatment arm, which were allowed to interact with age.

对于跑步机运动时间、压力超声心动图和问卷调查，使用了一个贝叶斯序数比例优势模型，包括了随机化前的值和治疗组，这些因素被允许与年龄进行交互作用。

Results

The mean age was 64 ± 9 years, ranging from 40 to 82 years.

平均年龄为64±9岁，年龄范围在40至82岁之间。

There was little relationship between age and symptom and stenosis severity.

年龄与症状和狭窄程度之间的关系不大。

In older patients, PCI was more effective for symptom relief (OR: 2.03; 95% CrI: 1.67-2.45; Pr > 0.99) than in younger patients (OR: 1.70; 95% CrI: 1.38-2.15; Pr > 0.99; Pr [interaction] = 0.99).

在老年患者中，与年轻患者相比，经皮冠状动脉介入治疗（PCI）在缓解症状方面更为有效（OR: 2.03; 95% CrI: 1.67-2.45; Pr > 0.99）（年轻患者OR: 1.70; 95% CrI: 1.38-2.15; Pr > 0.99; Pr [交互作用] = 0.99）。

In contrast, the effect of PCI on treadmill exercise time was far greater in younger than in older patients (50-year-old: +125 s [95% CrI: 35.8-215.0 s; Pr > 0.99]; 70-year-old: +31.9s [95% CrI: -12.6 to 78.3; Pr = 0.92]; Pr [interaction] = 0.96).

相比之下，PCI对年轻患者在跑步机运动时间上的效果远大于老年患者（50岁患者：+125秒 [95% CrI: 35.8-215.0秒; Pr > 0.99]；70岁患者：+31.9秒 [95% CrI: -12.6至78.3秒; Pr = 0.92]；Pr [交互作用] = 0.96）。

Conclusions

PCI was effective across all ages in reducing angina frequency.

PCI在减少各年龄段心绞痛发作频率方面均有效。

Notably, there was limited improvement in treadmill exercise time in the elderly, challenging its role as a primary endpoint in many antianginal trials.

值得注意的是，在老年人中，跑步机运动时间的改善有限，这对其在许多抗心绞痛试验中作为主要终点的角色提出了挑战。

These data should inform cardiovascular clinical trial design to ensure applicability across all ages.

这些数据应为心血管临床试验设计提供信息，以确保适用于所有年龄段。

(Objective Randomized Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina [ORBITA-2]; NCT03742050).

(目标随机双盲研究，对稳定型心绞痛患者进行最佳药物治疗的血管成形术 [ORBITA-2]; NCT03742050).