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Survival after percutaneous coronary intervention for chronic total occlusion in elderly patients

Aurel Toma1, Catherine Gebhard, Michael Gick

  • 1Division of Cardiology and Angiology II, University Heart Center Freiburg - Bad Krozingen, Bad Krozingen, Germany.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|November 22, 2016
PubMed

Insights

Elderly patients aged 75 and older benefit similarly to younger patients from successful percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) using drug-eluting stents (DES). This indicates CTO PCI should be considered for older individuals when clinically appropriate.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • Limited data exist on percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) in very elderly patients within the drug-eluting stent (DES) era.
  • Assessing long-term outcomes in this specific demographic is crucial for treatment guidelines.

Purpose of the Study:

  • To investigate the long-term survival rates of elderly patients (≥75 years) undergoing CTO PCI with DES.
  • To compare the survival benefits of successful CTO PCI in elderly versus younger patient cohorts.

Main Methods:

  • A single-center cohort study included 2,002 patients undergoing CTO PCI between 2005 and 2013.
  • Patients were stratified into elderly (≥75 years) and younger groups, with 409 patients in the elderly cohort.
  • Survival outcomes were analyzed using multivariate models, with a median follow-up of 2.6 years.

Main Results:

  • Successful CTO PCI was associated with significantly improved survival in both elderly (adjusted HR 0.58) and younger patients (adjusted HR 0.59).
  • The absolute reduction in all-cause mortality at three years was numerically greater in elderly patients (22.1%) compared to younger patients (7.2%).

Conclusions:

  • Elderly patients (≥75 years) experience a comparable survival benefit from successful CTO PCI in the DES era as younger patients.
  • These findings support the consideration of CTO PCI in elderly patients when the procedure is indicated.
Abstract

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