title: Survival after percutaneous coronary intervention for chronic total occlusion in elderly patients.
abstract: OBJECTIVE
  Few data are available on outcomes of percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) in very elderly patients in the drug-eluting stent (DES) era. We aimed to investigate long-term survival in a single-centre cohort of elderly patients following CTO PCI using DES.
  
  
  RESULTS
  A total of 2,002 consecutive patients who underwent PCI of a CTO at our centre between January 2005 and December 2013 were followed for a median of 2.6 years (interquartile range 1.1-3.1 years). Four hundred and nine (409) patients were older than 75 years. The absolute reduction in all-cause mortality by successful CTO PCI was numerically greater in elderly patients as compared to younger patients (22.1% vs. 7.2% at three years). In multivariate models, successful CTO PCI was significantly associated with improved survival in both elderly (adjusted hazard ratio [HR] 0.58, 95% confidence interval [CI]: 0.39 to 0.87; p=0.009) and younger patients (adjusted HR 0.59, 95% CI: 0.40 to 0.86; p=0.006).
  
  
  CONCLUSIONS
  In the DES era, elderly patients (≥75 years) derive a similar survival benefit from successful CTO PCI to younger patients. These findings suggest that CTO PCI, when indicated, should not be withheld from the elderly.
authors.affiliation: Division of Cardiology and Angiology II, University Heart Center Freiburg - Bad Krozingen, Bad Krozingen, Germany.
authors.forename: Aurel
authors.initials: A
authors.lastname: Toma
authors.forename: Catherine
authors.initials: C
authors.lastname: Gebhard
authors.forename: Michael
authors.initials: M
authors.lastname: Gick
authors.forename: Fadil
authors.initials: F
authors.lastname: Ademaj
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Stähli
authors.forename: Kambis
authors.initials: K
authors.lastname: Mashayekhi
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Ferenc
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Heinz Joachim
authors.initials: HJ
authors.lastname: Buettner
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D054059:Coronary Occlusion / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome