D-57 | Outcomes of chronic total occlusion percutaneous coronary intervention in young patients

There is limited information regarding outcomes of young patients undergoing percutaneous coronary interventions (PCI) for chronic total occlusion (CTO). We compared baseline clinical and angiographic characteristics, and procedural outcomes between young (age ≤50 years) and older (age >50 years) patients who underwent CTO PCI at 49 centers between 2012 and 2023. A total of 1,297 (9.8%) young and 11,950 (90.2%) older patients were treated. The mean age was 45±4 years for young and 67±8 years for older patients. Young patients had a lower prevalence of comorbidities, including diabetes (35.1% vs. 44.4%; p<0.001), hypertension (76.4% vs. 89.3%; p<0.001), and peripheral arterial disease (5.1% vs.15.0%; p=0.009), and were more likely to have a family history of premature coronary artery disease (44.3% vs 29.8%; p<0.001). Patients ≤50 years old had a lower J-CTO score (2.14 ± 1.26 vs. 2.40 ± 1.26; p<0.001), shorter procedure time (106 [70,155] min vs 112 [75,166] min; p<0.001), and required higher contrast volume (210 [150,300] ml vs. 200[144,290] ml; p<0.001) compared with >50-year-old patients. Technical (90.6% vs. 86.4%; p<0.001) and procedural (89.7% vs. 85.1%; p=0.001) success rates were higher in young patients, with similar in-hospital major adverse cardiovascular events (MACE) (1.3% vs. 2.0%; p=0.084). Young patients undergoing CTO PCI have fewer comorbidities and less complex lesions compared with older patients. They have higher technical and procedural success rates, with similar in-hospital MACE.