Key result
In patients ≥80 years with ischemic heart disease, CABG and PCI were associated with greater 4-year survival (77.4% and 71.6%, respectively) compared to medical therapy (60.3%).
Why the study?
Does CABG or PCI improve survival compared to medical therapy in elderly patients with ischemic heart disease?
Population
Patients with ischemic heart disease undergoing cardiac catheterization and revascularization in Alberta…
Comparison
Coronary artery bypass grafting or percutaneous… vs Medical therapy
Design
Cohort
Follow-up
4 years
Authors
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Revascularization was associated with better survival in octogenarians; leaves open whether randomized trials would confirm benefit over medical therapy.
Cohort (n=21,573)
Yes
Does CABG or PCI improve survival compared to medical therapy in elderly patients with ischemic heart disease?
Absolute Risk Reduction: 17
Absolute Event Rate: 77.4% vs 60.3%
Absolute Risk Reduction: 17%
Elderly patients (≥80 years) with ischemic heart disease derive a paradoxically greater absolute survival benefit from surgical or percutaneous revascularization compared to medical therapy than younger patients.
Graham et al. (2002) conducted a cohort in Ischemic heart disease (n=21,573). Coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) vs. Medical therapy was evaluated on 4-year adjusted actuarial survival (Absolute risk difference 17.0%). In patients ≥80 years with ischemic heart disease, CABG and PCI were associated with greater 4-year survival (77.4% and 71.6%, respectively) compared to medical therapy (60.3%).