Abstract

Feasibility and efficacy of complex percutaneous coronary intervention (PCI) in the elderly, a more frail population due to more comorbidities is incompletely understood. We therefore set out to compare success and complication rate of PCI for chronic total occlusion (CTO) in octogenarians, in comparison to non-octogenarians. Data from 267 patients (58 patients over 80 years of age and 209 under 80 years of age) who had undergone CTO PCI were analyzed. To compare the results we calculated the propensity score and used inverse probability of treatment weighting. We evaluated demographic, clinical, angiographic, and periprocedural information. The median age of the total collective was 68 (31–90) years (octogenarian collective 82 (80–90) years vs non-octogenarians 65 (31–79) years). We observed a high success rate in both collectives (82.8% vs 90.4%, p = 0.10) and no difference in periprocedural complications or complications in the follow-up period. In our collective restenosis rate at follow-up was comparable to the propensity sore weighted population (11.3% vs 16.3%, p = 0.9). Our results show that CTO PCI in older patients is safe and feasible with comparable in-hospital and follow-up complication rates compared to a younger patient population.

Highlights

  • Feasibility and efficacy of complex percutaneous coronary intervention (PCI) in the elderly, a more frail population due to more comorbidities is incompletely understood

  • In total two hundred and sixty-seven patients of the chronic total occlusion (CTO) PCI database were included in the study, 58 patients over 80 years of age and 209 younger patients

  • We found no difference in the New York Heart Association (NYHA) classification between the octogenarian and non-octogenarian collective (p 0.23) or the Cardiovascular Society grading of angina pectoris (CCS) classification (p 0.57)

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Summary

Introduction

Feasibility and efficacy of complex percutaneous coronary intervention (PCI) in the elderly, a more frail population due to more comorbidities is incompletely understood. We set out to compare success and complication rate of PCI for chronic total occlusion (CTO) in octogenarians, in comparison to non-octogenarians. Our results show that CTO PCI in older patients is safe and feasible with comparable in-hospital and follow-up complication rates compared to a younger patient population. Clinical evidence proving advantages after successful CTO recanalization like a reduction in mortality, improvement of left ventricular function or quality of life are almost exclusively based on cohorts of younger patients with less c­ omorbidities[2–4], whereas data on possible benefits of the treatment in elderly patients are scarce. The aim of our study was to investigate the feasibility of CTO recanalization, occurrence of complications and restenosis in a patient collective of octogenarians compared to non-octogenarians

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