Dataset Information

Outcomes of percutaneous coronary intervention for chronic total occlusions in the elderly: A systematic review and meta-analysis.

ABSTRACT:

Objective

This study aimed to compare outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) in the elderly (?75?years) versus nonelderly and assess the impact of successful CTO-PCI in the elderly.

Methods

PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched up to October 1, 2020. Mortality rates and major adverse cardiac events (MACE) were compared between elderly and nonelderly patients and successful versus failed CTO-PCI in the elderly.

Results

Eight studies were included. Meta-analysis indicated no statistically significant difference in the risk of in-hospital mortality (RR: 1.97 95% CI: 0.78, 4.96 I² =?0% p = .15) but higher tendency of in-hospital MACE (RR: 2.30 95% CI: 0.99, 5.35 I² =?49% p = .05) in the elderly group. Risk of long-term mortality (RR: 3.79 95% CI: 2.84, 5.04 I² =?41% p?2 =?80% p = .004) were significantly increased in the elderly versus nonelderly. Elderly patients had a significantly reduced odds of successful PCI as compared to nonelderly patients (OR: 0.63 95% CI: 0.54, 0.73 I² =?1% p?2 =?27% p = .001) and MACE (HR: 0.60 95% CI: 0.37, 0.97 I² =?53% p = .04) as compared to failed PCI in elderly.

Conclusions

Elderly patients may have a tendency of higher in-hospital MACE with significantly increased long-term mortality and MACE after CTO-PCI. The success of PCI is significantly lower in the elderly. In elderly patients with successful PCI, the risk of long-term mortality and MACE is significantly reduced.

SUBMITTER: Cui C

PROVIDER: S-EPMC7803357 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Outcomes of percutaneous coronary intervention for chronic total occlusions in the elderly: A systematic review and meta-analysis.

Cui Chenmin C Sheng Zhichao Z

Clinical cardiology 20201217 1

<h4>Objective</h4>This study aimed to compare outcomes of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) in the elderly (≥75 years) versus nonelderly and assess the impact of successful CTO-PCI in the elderly.<h4>Methods</h4>PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched up to October 1, 2020. Mortality rates and major adverse cardiac events (MACE) were compared between elderly and nonelderly patients and successful versus failed C ...[more]

PMID: 33332739

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Project description:ObjectiveThe initial recanalization rate of coronary chronic total occlusions (CTOs) is >85% when performed by experienced operators, but only 10% of prior failed CTO patients receive reattempted recanalization. This retrospective study analyzed the success rate and strategies used in reattempt percutaneous coronary intervention (PCI) of CTOs after prior failures.MethodsOverall, 206 patients with 212 CTOs were enrolled. All patients with prior recanalization failures received reattempt PCIs from January 2015 to March 2019 at Zhongshan Hospital, Fudan University. Data on clinical factors (age, sex, comorbidities, left ventricular ejection fraction, history of cigarette usage, and revascularization), angiographic characteristics of CTOs (target lesion, Japanese Chronic Total Occlusion (J-CTO) score, the morphology of CTO lesions, and collateral channel scale), strategies (procedural approach and use of devices), and major adverse events were obtained and analyzed.ResultsThe mean age of enrolled patients was 60.96 ± 12.36 years, with a male predominance of 90.3%. Of the patients, 47.1% had a prior myocardial infarction and 70.4% underwent stent implantation previously, while the in-stent occlusion rate was 6.6%. CTOs were primarily localized in the left anterior descending artery (43.9%) and the right coronary artery (43.9%). 80.7% of lesions were classified as very difficult (J-CTO score ≥3), and the overall success rate was 81.1%. In multivariable regression analysis, J-CTO score, collateral channel scale, application of coronary multispiral computed tomography angiography, dual injection, intravascular ultrasound, active greeting technique, parallel wiring, and CTO morphology were predictors of recanalization success. There were no significant differences in rates of procedural complications between the final recanalization success and failure groups.ConclusionsRecanalization of complex CTOs is associated with high success rate and low complication rates when performed by high-volume CTO operators and after multiple reattempts.

Dataset Information

Outcomes of percutaneous coronary intervention for chronic total occlusions in the elderly: A systematic review and meta-analysis.

Objective

Methods

Results

Conclusions

Publications

Outcomes of percutaneous coronary intervention for chronic total occlusions in the elderly: A systematic review and meta-analysis.

Similar Datasets

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