Abstract 9890: The Short- and the Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusions in Elderly Patients

Abstract

Introduction: We investigated the safety and the efficacy of percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) in elderly patients. Methods: Between 2005 and 2009, 301 consecutive patients underwent PCI for a total of 323 CTO lesions. The short and the long-term outcomes of PCI were retrospectively evaluated by comparing patients with ≥ 75 years (n = 71, 23.6%) and those with < 75 years (n = 230, 76.4%). Results: Procedural success was achieved in 78.7% of the patients in the elderly group and 78.2% in the younger group (P = 0.73). No significant differences were observed in the incidences of procedural-related complications between the two groups (2.8% vs. 5.2%; P = 0.40). At a mean follow-up of 3.1 years, the incidence of major adverse cardiac events (MACE: all-cause death, myocardial infarction and target lesion revascularization [TLR]) was significantly higher in the elderly group (27.8% vs. 5.4%; P < 0.001). TLR was not significantly different between the groups (12.4% vs. 19.2%; P = 0.64). When comparing patients with successful and failed PCI among elderly group, incidences of MACE did not show significant differences (54.0 vs. 66.0%; P = 0.53). However, those with successful PCI showed significantly improved cardiac survival compared to those with failed PCI (92.2% vs. 72.0%; P = 0.011), the level of which was similar to those observed in the younger group irrespective of their procedural success (98.7% with successful PCI and 100% with failed PCI). After multivariate analysis, only successful PCI was found to be the independent factor associated with a reduction of cardiac death in the elderly group (HR: 0.134; 95% CI: 0.022-0.815; P = 0.029). Conclusions: This retrospective study demonstrates that PCI for CTO lesions in elderly patients is associated with the improved cardiac survival after successful PCI. PCI for CTO lesions may become a viable treatment strategy even in elderly patients.