Background Data regarding the impact of successful chronic total occlusion treated with percutaneous coronary intervention (CTO-PCI) on symptoms and quality of life (QOL) in elderly patients (≥75 years) are unknown. This prospective study aimed to assess whether successful CTO-PCI could improve the symptoms and QOL in elderly patients (≥75 years). Methods and Results Consecutive patients who underwent elective CTO-PCI were prospectively enrolled and subdivided into 3 groups based on age: age<65 years, 65 years≤age<75 years, and age≥75 years. The primary outcomes included symptoms, as assessed with the New York Heart Association functional class and Seattle Angina Questionnaire, and QOL, as assessed with the 12-Item Short-Form Health Survey questionnaire, at baseline, 1 month, and 1 year after successful CTO-PCI. Of 1076 patients with CTO, 101 were age≥75 years (9.39%). Hemoglobin, estimated glomerular filtration rate, and left ventricular ejection fraction levels all decreased with increasing age, and NT-proBNP (N-terminal pro-B-type natriuretic peptide) increased. The proportion of dyspnea and coronary lesions, including multivessel disease, multi-CTO lesion, and calcification were higher in elderly patients. Procedural success rate, intraprocedural complications, and in-hospital major adverse cardiac events were not statistically different in the 3 groups. Importantly, symptoms, including dyspnea and angina, were markedly improved regardless of age at 1-month and 1-year follow-up (P<0.05). Likewise, successful CTO-PCI significantly improved QOL at 1-month and 1-year follow-up (P<0.01). Additionally, the incidence of major adverse cardiac events and all-cause mortality at 1-month and 1-year follow-up was not statistically different in the 3 groups. Conclusions Successful PCI was beneficial and feasible to improve symptoms and QOL in patients ≥75 years of age with CTO.
Keywords: chronic total occlusion; clinical outcomes; elderly patient; percutaneous coronary intervention; quality of life; symptoms.