title: Comparison of short- and long-term outcomes of percutaneous coronary intervention for chronic total occlusions between patients aged ≥75 years and those aged <75 years.
abstract: Few reports are available on the safety and efficacy of percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) in older patients. In the present study, 284 patients who underwent PCI for CTOs were retrospectively evaluated by comparing the characteristics of 67 patients aged ≥75 years (the older group) and 217 patients aged <75 years (the younger group). Technical success was achieved in 77% of the patients in the older group and 79% of those in the younger group (p = 0.66). No significant differences were observed between the 2 groups in terms of the incidence of procedural complications. In the older group, a comparison between the patients with successful and failed PCI revealed significantly superior 3-year cardiac survival (97.6% vs 76.9%, p = 0.005). The 3-year cardiac survival of those with successful PCI was similar to that observed in the younger group. On multivariate analysis, successful PCI was found to be associated with a lower incidence of cardiac death in the older group (hazard ratio 0.09, 95% confidence interval 0.01 to 0.91, p = 0.042). In conclusion, this single-center, observational study suggests that PCI for CTOs can be performed with a high rate of procedural success and acceptably low mortality and morbidity in older patients, resulting in improved cardiac survival. Thus, PCI for CTO lesions should be included among the treatment strategies for older patients.
authors.affiliation: Division of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan. yutakatanaka_circ@yahoo.co.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takeshita
authors.forename: Saeko
authors.initials: S
authors.lastname: Takahashi
authors.forename: Junya
authors.initials: J
authors.lastname: Matsumi
authors.forename: Shingo
authors.initials: S
authors.lastname: Mizuno
authors.forename: Futoshi
authors.initials: F
authors.lastname: Yamanaka
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sugitatsu
authors.forename: Yu
authors.initials: Y
authors.lastname: Nomura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Imori
authors.forename: Koki
authors.initials: K
authors.lastname: Shishido
authors.forename: Kazuki
authors.initials: K
authors.lastname: Tobita
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome