Key result
Elderly patients undergoing PCI for chronic total occlusions had similar in-hospital mortality but higher long-term mortality (RR 3.79; 95% CI 2.84-5.04; p<0.00001) compared to nonelderly patients.
Why the study?
Outcomes of percutaneous coronary intervention for chronic total occlusions in the elderly versus nonelderly and the impact of successful CTO-PCI in the elderly were unclear.
Does percutaneous coronary intervention for chronic total occlusions yield different outcomes in elderly versus nonelderly patients, and does successful PCI improve outcomes in the elderly?
Comparison
Elderly (≥75 years) vs nonelderly, and successful vs failed CTO-PCI in elderly
Design
Systematic review and meta-analysis
Authors
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May support attempted CTO-PCI in select elderly patients when feasible; leaves open need for randomized trials versus medical therapy.
Meta-Analysis
Does percutaneous coronary intervention for chronic total occlusions yield different outcomes in elderly versus nonelderly patients, and does successful PCI improve outcomes in the elderly?
Relative Risk: 1.97 (95% CI 0.78–4.96)
p-value: p=.15
While elderly patients undergoing CTO-PCI have higher long-term mortality and lower procedural success than nonelderly patients, successful revascularization in the elderly is associated with significantly reduced long-term mortality and MACE compared to failed procedures.
Cui et al. (2020) conducted a meta-analysis in chronic total occlusions. Elderly age (≥75 years) vs. Nonelderly was evaluated on in-hospital mortality (RR 1.97, 95% CI 0.78, 4.96, p=.15). Elderly patients undergoing PCI for chronic total occlusions had similar in-hospital mortality but higher long-term mortality (RR 3.79; 95% CI 2.84-5.04; p<0.00001) compared to nonelderly patients.
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