In-hospital and long-term outcomes after percutaneous coronary intervention for chronic total occlusion in elderly patients: A consecutive, prospective, single-centre study

Background. Elderly patients are increasingly referred for complex percutaneous coronary interventions (PCI), including recanalization of chronic total occlusion (CTO). Aims. To assess the feasibility, safety and clinical benefits associated with CTO-PCI in elderly patients. Methods. Consecutive patients (n=356) who underwent CTO-PCI in our institution between January 2008 and December 2011 were prospectively included. The short-term outcomes of CTO-PCI were assessed by comparing the rates of successful recanalization and postoperative complications in patients aged >= 75 years and those <75 years. The clinical effect of successful recanalization was evaluated' in a 20-month follow-up analysis in patients >= 75 years. Results. Although patients >= 75 years (n = 93) had more complex coronary artery disease, the procedural success rate was similar to that in younger patients (78.2% vs. 74.3%, respectively; P=0.41). Postoperative complications were more frequent in older patients (5.4% vs. 0.4%; P=0.005). Major adverse cardiac event -free survival analysis at 20 months revealed that successful revascularization was indicative of a better prognosis in older patients (hazard ratio: 0.43, 95% confidence interval: 0.19-0.96; P=0.039). Conclusion. Elderly patients have more complex coronary disease and are at a higher risk of postoperative complications. Nevertheless, we observed a similar success rate for CTO-PCI in elderly patients as for younger patients. Successful CTO recanalization improved the event free survival rate at 20 months. Thus, CTO-PCI constitutes an alternative strategy for treating selected elderly patients. (C) 2015-Elsevier Masson SAS. All rights reserved.