Background

Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and high target failure. The impact of percutaneous coronary intervention (PCI) for CTO in elder patients is not clear. We evaluated the 12-month clinical outcomes between intervention and medical therapy for CTO lesions in elder patients.

Methods

A total of 303 consecutive CTO patients of ages ≥65 were divided into 2 groups according to treatment; one group underwent intervention (PCI group; n=101) and the other group was treated with medical therapy (Mx group; n=202). 12-month clinical outcomes were compared between the two groups.

Results

At baseline, patients in the PCI group showed a higher prevalence of prior PTCA and LAD-CTO. Patients in the Mx group showed higher prevalence of left main disease, LAD lesion, LCX lesion, RCA lesion, multivessel disease, multivessel CTO, RCA-CTO, and collateral vessels(≥grade 2). Clinical outcomes at 12 months were balanced between the 2 groups. Similar results were observed after baseline adjustment by multivariate analysis.

Conclusions

In our study, no significant difference was observed between interventional therapy and medical therapy for elderly CTO patients. Long-term follow up with a larger study population will be necessary for further evaluation.

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.