Date of Award

5-2016

Degree Type

Internship Practicum Report

Degree Name

Master of Science

Field of Study

Clinical Research Management

Department

Graduate School of Biomedical Sciences

First Advisor

Patricia A. Gwirtz

Second Advisor

Emmanouil S. Brilakis

Third Advisor

Michael L. Smith

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 (<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 <65, 65-75, and ≥75 years old respectively, p <0.001) and prior coronary artery bypass graft surgery (25.2% vs 39.8% vs 45.5%, p <0.001), but lower prevalence of current smoking (36.4% vs 25.7% vs 14.6%, p <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 <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.

Comments

Iwnetu, Rahel. Impact of Age on Technical and In-hospital Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusions. Master of Science (Clinical Research Management), March, 2016, 99 pp., 3 tables, 1 figure, 95 bibliographies, 32 titles.

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