Database Conference Washington D.C. Do existing databases answer clinical questions about geriatric cardiovascular disease and stroke?

Most randomized, controlled trials evaluating the effectiveness of pharmaceutical, surgical, and device interventions for the prevention and treatment of cardiovascular disease have excluded patients over 75 years of age. Consequently, the use of these therapies in the older population is based on extrapolation of safety and effectiveness data obtained from younger patients. However, there are many registries and observational databases that contain large amounts of data on patients 75 years of age and older, as well as on younger patients. Although conclusions from such data are limited, it is possible to define the characteristics of patients who did well and those who did poorly. The goal of this conference was to convene the principal investigators of these databases, and others in the field of geriatric cardiology, to address questions relating to the safety and effectiveness of treatment interventions for several cardiovascular conditions in the elderly. Seven committees discussed the following topics: I. Risk Factor Modification in the Elderly II. Chronic Heart Failure III. Chronic Coronary Artery Disease: Role of Revacularization IV. Acute Myocardial Infarction V. Valve Surgery in the Elderly VI. Electrophysiology, Pacemaker, and Automatic Internal Cardioverter Defibrillators Databases VII. Carotid Endarterectomy in the Elderly The chairs of these committees were asked to invite principal investigators of key databases in each of these areas to discuss and prepare a written statement concerning the available safety and efficacy data regarding interventions for these conditions and to identify and prioritize areas for future study. The ultimate goal is to stimulate further collaborative outcomes research in the elderly so as to place the treatment of cardiovascular disease on a more scientific basis.