Successful percutaneous coronary intervention for chronic total occlusion in elderly patients (≥75 years) was associated with improved survival (adjusted HR 0.58; 95% CI 0.39-0.87; p=0.009).
Cohort (n=2,002)
No
Does successful CTO PCI using drug-eluting stents improve long-term survival in elderly patients (≥75 years)?
Successful CTO PCI using drug-eluting stents is associated with a significant survival benefit in elderly patients (≥75 years), comparable to the benefit observed in younger patients.
Effect estimate: HR 0.58 (95% CI 0.39-0.87)
p-value: p=0.009
AIMS: Few data are available on outcomes of percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) in very elderly patients in the drug-eluting stent (DES) era. We aimed to investigate long-term survival in a single-centre cohort of elderly patients following CTO PCI using DES. METHODS AND RESULTS: A total of 2,002 consecutive patients who underwent PCI of a CTO at our centre between January 2005 and December 2013 were followed for a median of 2.6 years (interquartile range 1.1-3.1 years). Four hundred and nine (409) patients were older than 75 years. The absolute reduction in all-cause mortality by successful CTO PCI was numerically greater in elderly patients as compared to younger patients (22.1% vs. 7.2% at three years). In multivariate models, successful CTO PCI was significantly associated with improved survival in both elderly (adjusted hazard ratio HR 0.58, 95% confidence interval CI: 0.39 to 0.87; p=0.009) and younger patients (adjusted HR 0.59, 95% CI: 0.40 to 0.86; p=0.006). CONCLUSIONS: In the DES era, elderly patients (≥75 years) derive a similar survival benefit from successful CTO PCI to younger patients. These findings suggest that CTO PCI, when indicated, should not be withheld from the elderly.
Toma et al. (Thu,) conducted a cohort in Coronary chronic total occlusions (CTO) (n=2,002). Successful percutaneous coronary intervention (PCI) using drug-eluting stents vs. Unsuccessful CTO PCI was evaluated on All-cause mortality (survival) (HR 0.58, 95% CI 0.39-0.87, p=0.009). Successful percutaneous coronary intervention for chronic total occlusion in elderly patients (≥75 years) was associated with improved survival (adjusted HR 0.58; 95% CI 0.39-0.87; p=0.009).