Trial of Invasive versus Medical Therapy in the Elderly (TIME)

Background: The risk associated with revascularization (coronary artery bypass-graft surgery and percutaneous coronary interventions) is increased in elderly patients with chronic symptomatic coronary artery disease (CAD) and may outweigh the benefit compared to optimal medical management in this patient group. Patients and Methods: Patients aged ≧75 years with angina Canadian Cardiac Society class ≧II despite at least two antiangial drugs are prospectively enrolled in 14 Swiss centers. They are randomized to coronary angiography and revascularization if possible or to optimized medical therapy and followed up for 6 and 12 months. The primary endpoint is quality of life, assessed by a self-administered structured questionnaire at baseline and after 6 months and occurrence of a composite endpoint of: death, myocardial infarction or hospitalization for acute coronary syndrome/need for revascularization. Results and Relevance: Preliminary data show that included patients meet the goals of the trial. Results will define the role of revascularization in these patients with significant management and cost implications.