February 22, 2013Catheterization and Cardiovascular Interventions
Long‐term clinical outcomes after percutaneous coronary intervention for chronic total occlusions in elderly patients (≥75 Years)
Key result
In elderly patients (≥75 years) undergoing PCI for chronic total occlusions, successful revascularization was associated with a lower rate of MACE compared to failed PCI (25.8% vs. 42.3%, P=0.02).
Why the study?
Does successful PCI for CTO reduce MACE compared to failed PCI in elderly patients (≥75 years)?
Population
1,791 consecutive patients with 1,852 chronic total occlusions undergoing percutaneous coronary intervention…
Comparison
Successful percutaneous coronary intervention… vs Failed percutaneous coronary intervention for…
Design
Cohort
Follow-up
median 890 days (IQR: 380-1,480 days)
Authors
Discussion
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Implication
May support individualized CTO PCI attempts in elderly patients; hypothesis-generating and requires randomized confirmation.
Study Design
Type
Cohort (n=1,791)
Multicenter
Yes
Structured PICO
Does successful PCI for CTO reduce MACE compared to failed PCI in elderly patients (≥75 years)?
P
Population
1,791 consecutive patients undergoing percutaneous coronary intervention for chronic total occlusions across three countries, followed for a median of 890 days.
E
Exposure
Successful percutaneous coronary intervention (PCI) for chronic total occlusions (CTO)
C
Comparator
Failed percutaneous coronary intervention (PCI) for chronic total occlusions (CTO)
O
Outcome
Procedural success and major adverse cardiac events (MACE, composite of mortality, myocardial infarction, or coronary artery bypass graft surgery [CABG])composite
Main Result
Absolute Event Rate: 25.8% vs 42.3%
p-value: p=0.02
Successful PCI for CTO is associated with a significant reduction in long-term MACE in both elderly (≥75 years) and younger patients, primarily driven by a reduction in CABG in the elderly.
Cite This Study
Hoebers et al. (2013) conducted a cohort in Chronic total occlusions (CTO) (n=1,791). Successful percutaneous coronary intervention vs. Failed percutaneous coronary intervention was evaluated on Major adverse cardiac events (MACE, composite of mortality, myocardial infarction, or CABG) (p=0.02). In elderly patients (≥75 years) undergoing PCI for chronic total occlusions, successful revascularization was associated with a lower rate of MACE compared to failed PCI (25.8% vs. 42.3%, P=0.02).