Impact of age on technical and in-hospital outcomes of percutaneous coronary intervention for chronic total occlusions

Abstract

Background: We sought to examine the effect of patient age on the outcomes of percutaneous coronary intervention (PCI) of chronic total occlusions (CTO). Methods: We examined clinical and angiographic data as well as outcomes of 1,216 CTO PCIs performed in 1,195 patients divided into three age groups ([less than] 65, 65-75, and ≥75 years old). Results: Increasing age was associated with higher prevalence of prior stroke (7.6% vs 12.6% vs 17.2% for [less than] 65, 65-75, and ≥75 years old respectively, p [less than] 0.001) and prior coronary artery bypass graft surgery (25.2% vs 39.8% vs 45.5%, p [less than] 0.001), but lower prevalence of current smoking (36.4% vs 25.7% vs 14.6%, p [less than] 0.001). Older patients were also more likely to have hypertension (88.1% vs 88.7% vs 94.0%, p=0.042) and have moderately or severely calcified lesions (48.4% vs 59.8% vs 75.0%, p [less than] 0.001). Technical success rate was similar in all age groups (91.1% vs 90.7% vs 85.7%, p=0.054), but a higher incidence of major adverse cardiac events (MACE) was noted in the ≥75 years old group (0.9% vs 3.0% vs 5.1%, p=0.002), largely due to higher rate of cardiac tamponade requiring pericardiocentesis (0% vs 0.7% vs 2.2%, p=0.004). Procedure time, contrast volume and air kerma radiation dose did not differ significantly between the three groups. Conclusion: CTO PCI can be performed with high success rates among older patients, but may carry higher risk for complications in this patient group.