title: Long-term outcomes of high-risk elderly male patients with multivessel coronary disease: optimal medical therapy versus revascularization.
abstract: BACKGROUND
  Many studies have indicated that medical therapy and percutaneous coronary intervention have similar effects in terms of the long-term prognosis of patients with stable coronary artery disease. This study investigated the effects of optimal medical therapy (OMT) and revascularization-plus-OMT in elderly patients with high-risk angina.
  
  
  METHODS
  In this prospective non-randomized study, 241 consecutive high-risk elderly male patients (65-92 years of age) with angiographically confirmed multivessel disease were enrolled in the registry from January 2004 to April 2005. Of these, 98 patients underwent OMT and 143 underwent revascularization therapy plus OMT.
  
  
  RESULTS
  After 6.5 years of follow-up, we found that the rate of long-term cardiac mortality was significantly higher in patients who underwent OMT than in those who underwent revascularization (6.5-year unadjusted mortality rate, 14.3% for OMT vs. 7.0% for revascularization patients; log-rank P = 0.04). However, the overall risks of major adverse cardiac cerebrovascular events (MACCE) were similar among all patients (6.5-year unadjusted mortality rate, 29.6% for OMT vs. 27.3% for revascularization patients; log-rank P = 0.67).
  
  
  CONCLUSIONS
  OMT was associated with an increase in cardiac death but a similar 6.5-year risk of MACCE compared with revascularization in high-risk elderly male patients with coronary multivessel disease.
authors.affiliation: First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Tao
authors.affiliation: First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing, China.
authors.forename: Shu-Xia
authors.initials: SX
authors.lastname: Wang
authors.affiliation: First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Guo
authors.affiliation: First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhu
authors.affiliation: First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Wang
keywords: Coronary multivessel disease; High risk; Optimal medical therapy; Revascularization; The elderly