Abstract 12646: Health Status Outcomes in Older Adults Undergoing Chronic Total Occlusion Percutaneous Coronary Intervention

Abstract

Background: Although CTOs are common in older adults, they are less likely to be offered CTO percutaneous coronary intervention (PCI) for angina relief than younger adults. The health status impact of CTO PCI in adults ≥75 years old has not been studied. We sought to compare technical success rates and angina-related health status outcomes at 12-months between adults ≥75 and <75 years old in the OPEN-CTO registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Registry). Methods: Angina-related health status was assessed with the Seattle Angina Questionnaire (SAQ; score range 0-100, higher scores denote less angina). Technical success rates were compared using hierarchical modified Poisson regression, and 12-month health status was compared using hierarchical multivariable linear regression between adults ≥75 and <75 years old. Results: Of the 1000 patients enrolled, 19.8% were ≥75 years old with a mean age of 79.5 ± 4.1 years. Age ≥75 years was associated with a lower likelihood of technical success (adjusted RR = 0.92, 95% CI 0.86, 0.99, p=0.02) and numerically higher rates of in-hospital major adverse cardiovascular events (9.1% vs 5.9%, p=0.10). There was no difference in SAQ Summary Score at 12-months between adults ≥75 and <75 years old (adjusted difference 0.9, 95% CI -1.4, 3.1, p=0.44) (Figure). Conclusions: Despite modestly lower success rates and higher complication rates, adults ≥75 years old experienced angina-related health status benefits after CTO-PCI that were similar in magnitude to adults <75 years old. CTO PCI should not be withheld based on age alone in otherwise appropriate candidates.