Premium
Chronic total occlusion percutaneous coronary intervention in octogenarians and nonagenarians
Author(s) -
Vemmou Evangelia,
Alaswad Khaldoon,
Patel Mitul,
Mahmud Ehtisham,
Choi James W.,
Jaffer Farouc A.,
Doing Anthony H.,
Dattilo Phil,
Karmpaliotis Dimitri,
Krestyaninov Oleg,
Khelimskii Dmitrii,
Nikolakopoulos Ilias,
Karacsonyi Judit,
Xenogiannis Iosif,
Garcia Santiago,
Burke M. Nicholas,
Abi Rafeh Nidal,
ElGuindy Ahmed,
Goktekin Omer,
Abdo Abir,
Rangan Bavana V.,
Abdullah Shuaib,
Brilakis Emmanouil S.
Publication year - 2021
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.17063
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , mace , cardiology , incidence (geometry) , atrial fibrillation , population , surgery , myocardial infarction , physics , environmental health , optics
Objective The outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in octogenarians and nonagenarians have received limited study. Methods We compared in‐hospital outcomes of CTO PCI between patients ≥80 vs. <80‐years‐old in 6233 CTO PCIs performed between 2012 and 2020 at 33 U.S. and international centers. Results There were 415 octogenarians and nonagenarians in our study (7% of the total population). Compared with younger patients, octo‐ and nonagenarians were less likely to be men (73% vs. 83.2%, p < 0.0001) and more likely to have atrial fibrillation (27% vs. 12%, p < 0.0001) and prior coronary artery bypass graft surgery (CABG) (43% vs. 29%, p < 0.0001). They were more likely to have CTOs with moderate/severe calcification (71% vs. 46%, p < 0.0001), but had similar mean J‐CTO scores (2.5 ± 1.3 vs. 2.4 ± 1.3, p = 0.08). They had lower technical and procedural success (82.2% vs. 86.3%, p = 0.0201; 80.3% vs. 84.8%, p = 0.016, respectively) and higher incidence of in‐hospital major adverse cardiovascular events (3.4% vs. 1.8%, p = 0.021). On multivariable analysis PCI in octo‐ and nonagenarians was not independently associated with technical and procedural success or with in‐hospital MACE. Conclusion CTO PCI is feasible in octo‐ and nonagenarians, although success rates are lower, and the risk of complications is higher compared with younger patients, likely related to more comorbidities and higher coronary lesion complexity.