Background: Many of studies presented that successful revascularization for chronic total occlusion (CTO) improved clinical outcomes. However, there were limited data regarding the impact of percutaneous coronary intervention (PCI) for CTO in elderly patients (age ≥ 65).
Methods: A total of 424 consecutive CTO pts with age ≥ 65 were divided into 2 groups; one group underwent successful PCI (PCI group; n=177) and the other group was treated with OMT (OMT group; n=247). We compared major clinical outcomes of pts treated by PCI with optimal medical therapy (OMT) for CTO lesions in elderly pts up to 5 years.
Results: At baseline, the OMT group was older age and had higher prevalence of current smokers, de novo CTO, multi-vessel disease, multi-vessel CTO and lower left ventricular ejection fractions, whereas the PCI group had a higher prevalence of prior myocardial infarction (MI), prior PCI, diabetes mellitus, left anterior descending (LAD) artery CTO. After baseline adjustment by cox proportional hazards regression, clinical outcomes up to 5 years showed that the PCI group was associated with lower incidence of the composite of total death or MI despite of higher incidence of target lesion and target vessel revascularization (Table).
Conclusions: In our study, mechanical revascularization by PCI for CTO lesions in eldely pts reduces the incidence of the composite of total death or MI despite of higher repeat revascularization.