P68 PERCUTANEOUS REVASCULARIZATION OF CORONARY CHRONIC OCCLUSIONS IN THE ELDERLY: EFFICACY AND SAFETY

Abstract

Abstract Background Percutaneous revascularization (PCI) of coronary total occlusions (CTO) is an effective treatment of refractory angina. This procedure presents higher procedural risks than routine PCI. For this reason PCI CTO is often not considered a viable option for elderly patients. The aim of the work is to evaluate the efficacy and safety of CTO PCI in a population over 75 years of age. Materials and Methods We considered patients undergoing CTO PCI from 2015 to 2021 in our center. Primary efficacy endpoint was the incidence of major adverse cardiovascular events (MACE) during follow–up in older subjects compared to younger subjects. Endpoints include target vessel revascularization (TVR), urgent non–target vessel revascularization, and cardiovascular death. Safety endpoints were considered complications intra–procedure, during hospitalization and 15 days after discharge. MACE–free survival rates were assessed with Kaplan–Meier analysis. Results 127 patients were included, 30 aged more than 75 years (24%). The follow–up was 22 months. 86% were male. 32% were suffering from diabetes, 8% from chronic renal failure (creatinine > 2 mg / ml), 76% from arterial hypertension, 40% were familiar with ischemic heart disease. No significant differences are reported in the distribution of risk factors between the two groups. The average age in younger group is 69 years compared to 79 in the elderly. In the follow–up, 16 MACE were found (1 death from cardiac arrest, 14 TVR, 1 non–target vessel revascularization). TVR was the most common endpoint, in 90% of cases this revascularization took place by election. Four events (13%) occurred in the group over 75 years and 12 cases (12%) in the other group (n = ns). Kaplan–Meier MACE–free survival rates were similar. Only 3 complications related to the procedure (2.5%) were reported and these are coronary perforations effectively managed in the hemodynamics room. The success rate of the revascularization procedure was similar (80% for those over 75 versus 82% for the younger group). Conclusions in our population age did not influence the efficacy and safety of CTO PCI which represents a valid option for refractory angina even in older patients.