title: Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina--on-treatment analysis of the TIME trial.
abstract: OBJECTIVE
  To assess treatment effects of optimised medical therapy and PCI or CABG surgery on one-year outcome in patients 75 years old with chronic angina.
  
  
  RESULTS
  On-treatment analysis of the TIME data: all re-vascularised patients (REVASC n=174: 112 randomised to revascularisation and 62 to drugs with late revascularisation) were compared to all patients on continued drug therapy (MED n=127: 86 randomised to drugs and 41 to revascularisation only). Baseline characteristics of both groups were similar (age 80 +/- 4 years). Risk of death at one year (adjusted hazard ratio (HR)=1.31; 95%-CI: 0.58-2.99; P=0.52) and of death/infarction (adjusted hazard RATIO=1.77; 95%-CI 0.91-3.41; P=0.09) were comparable between REVASC and MED patients. Furthermore, the risk of death within 30 days was even slightly lower among REVASC patients (unadjusted hazard RATIO=0.73; 95%-CI: 0.21-2.53; P=0.98). Overall, REVASC patients had greater improvements in symptoms and well-being than MED patients (P<0.01). Surgical patients had similar mortality rates as angioplasty patients, but they also had greater symptomatic improvements (P<0.01).
  
  
  CONCLUSIONS
  Treated medically, elderly patients with chronic angina have a similarly high 30-day and one-year mortality as patients of the same age being re-vascularised; however, they can expect lower improvements in symptoms and well being.
authors.affiliation: Department of Cardiology, University Hospitals Basel, Petersgraben 4, 4031 Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kaiser
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Kuster
authors.forename: Paul
authors.initials: P
authors.lastname: Erne
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Amann
authors.forename: Barbara
authors.initials: B
authors.lastname: Naegeli
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
authors.forename: Peter
authors.initials: P
authors.lastname: Buser
authors.forename: Heinz
authors.initials: H
authors.lastname: Schläpfer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Brett
authors.forename: Hans-Reinhard
authors.initials: HR
authors.lastname: Zerkowski
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Matthias
authors.initials: M
authors.lastname: Pfisterer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000401:mortality / Q000628:therapy*; D000800:Angioplasty, Balloon / Q000401:mortality; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization / Q000379:methods* / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents