Persons aged 80 and above are the fastest growing age group in the United States population, having in-creased 50% since 1990 and predicted to grow another 25 % by 2020. As this aging population grows, heart dis-ease remains the leading cause of death, accounting for 30% of deaths in the 75-84 age group and 37% for those aged greater than 85 years. Similar trends are apparent throughout much of the rest of the world. As the elderly population increases and technology advances, more and more elderly patients undergo coronary angiography and percutaneous coronary intervention (PCI). In a large se-ries of patients from Northern New England in the US, 4% of all PCI procedures were performed in patients aged 80 or greater between 1989 and 1993, increasing to 8%-9% of all PCI procedures in 1998-2003 ,2'3 In an even larger metanalysis of combined studies, the incidence of PCI in patients aged 75 or older increased between 1990 and 1999 from 12% to 22%.