BACKGROUND: Elderly patients are increasingly referred for complex percutaneous coronary interventions (PCI), including recanalization of chronic total occlusion (CTO). AIMS: To assess the feasibility, safety and clinical benefits associated with CTO-PCI in elderly patients. METHODS: Consecutive patients (n=356) who underwent CTO-PCI in our institution between January 2008 and December 2011 were prospectively included. The short-term outcomes of CTO-PCI were assessed by comparing the rates of successful recanalization and postoperative complications in patients aged ≥ 75 years and those < 75 years. The clinical effect of successful recanalization was evaluated in a 20-month follow-up analysis in patients ≥ 75 years. RESULTS: Although patients ≥ 75 years (n = 93) had more complex coronary artery disease, the procedural success rate was similar to that in younger patients (78.2% vs. 74.3%, respectively; P = 0.41). Postoperative complications were more frequent in older patients (5.4% vs. 0.4%; P = 0.005). Major adverse cardiac event-free survival analysis at 20 months revealed that successful revascularization was indicative of a better prognosis in older patients (hazard ratio: 0.43, 95% confidence interval: 0.19-0.96; P = 0.039). CONCLUSION: Elderly patients have more complex coronary disease and are at a higher risk of postoperative complications. Nevertheless, we observed a similar success rate for CTO-PCI in elderly patients as for younger patients. Successful CTO recanalization improved the event-free survival rate at 20 months. Thus, CTO-PCI constitutes an alternative strategy for treating selected elderly patients.
BACKGROUND: Elderly patients are increasingly referred for complex percutaneous coronary interventions (PCI), including recanalization of chronic total occlusion (CTO). AIMS: To assess the feasibility, safety and clinical benefits associated with CTO-PCI in elderly patients. METHODS: Consecutive patients (n=356) who underwent CTO-PCI in our institution between January 2008 and December 2011 were prospectively included. The short-term outcomes of CTO-PCI were assessed by comparing the rates of successful recanalization and postoperative complications in patients aged ≥ 75 years and those < 75 years. The clinical effect of successful recanalization was evaluated in a 20-month follow-up analysis in patients ≥ 75 years. RESULTS: Although patients ≥ 75 years (n = 93) had more complex coronary artery disease, the procedural success rate was similar to that in younger patients (78.2% vs. 74.3%, respectively; P = 0.41). Postoperative complications were more frequent in older patients (5.4% vs. 0.4%; P = 0.005). Major adverse cardiac event-free survival analysis at 20 months revealed that successful revascularization was indicative of a better prognosis in older patients (hazard ratio: 0.43, 95% confidence interval: 0.19-0.96; P = 0.039). CONCLUSION: Elderly patients have more complex coronary disease and are at a higher risk of postoperative complications. Nevertheless, we observed a similar success rate for CTO-PCI in elderly patients as for younger patients. Successful CTO recanalization improved the event-free survival rate at 20 months. Thus, CTO-PCI constitutes an alternative strategy for treating selected elderly patients.
Authors: Barbara Anna Danek; Aris Karatasakis; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W Yeh; Farouc A Jaffer; Mitul P Patel; Ehtisham Mahmud; William L Lombardi; Michael R Wyman; J Aaron Grantham; Anthony Doing; David E Kandzari; Nicholas J Lembo; Santiago Garcia; Catalin Toma; Jeffrey W Moses; Ajay J Kirtane; Manish A Parikh; Ziad A Ali; Judit Karacsonyi; Bavana V Rangan; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: J Am Heart Assoc Date: 2016-10-11 Impact factor: 5.501
Authors: Noman Lateef; Muhammad Junaid Ahsan; Hafiz Muhammad Fazeel; Abdul Haseeb; Azka Latif; Omar Kousa; Mohsin Mirza; Mark Holmberg Journal: J Community Hosp Intern Med Perspect Date: 2020-02-10
Authors: Recha R L Blessing; Majid Ahoopai; Martin Geyer; Moritz Brandt; Andreas M Zeiher; Mariuca Vasa-Nicotera; Thomas Münzel; Philip Wenzel; Tommaso Gori; Zisis Dimitriadis Journal: Sci Rep Date: 2022-02-23 Impact factor: 4.379