Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina--on-treatment...

Area of Science:

• Cardiology
• Geriatric Medicine
• Interventional Cardiology

Background:

• Elderly patients (≥75 years) with chronic angina often present complex treatment decisions.
• Optimized medical therapy, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) are treatment options.
• Assessing the comparative effectiveness of these strategies in older adults is crucial.

Purpose of the Study:

• To evaluate the one-year outcomes of optimized medical therapy versus revascularization (PCI or CABG) in patients aged 75 and older with chronic angina.

Main Methods:

• On-treatment analysis of the TIME trial data.
• Comparison of revascularized patients (REVASC) with those on continued drug therapy (MED).
• Analysis included mortality, death/infarction, and symptom/well-being improvements.

Main Results:

• One-year mortality and death/infarction risks were comparable between REVASC and MED groups.
• 30-day mortality risk was slightly lower in the REVASC group.
• Revascularized patients reported significantly greater improvements in symptoms and well-being compared to medically treated patients.

Conclusions:

• In elderly patients with chronic angina, revascularization (PCI/CABG) offers similar mortality rates to optimized medical therapy at 30 days and one year.
• Revascularization leads to superior improvements in symptoms and quality of life compared to medical management in this age group.