The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention

Aris Karatasakis, Rahel Iwnetu, Barbara A. Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A. Jaffer, Robert W. Yeh, David E. Kandzari, Nicholas J. Lembo, Mitul Patel, Ehtisham Mahmud, William L. Lombardi, R. Michael Wyman, J. Aaron Grantham, Anthony H. Doing, Catalin Toma, James W. Choi, Barry F. Uretsky, Jeffrey W. Moses, Ajay J. KirtaneZiad A. Ali, Manish Parikh, Judit Karacsonyi, Bavana V. Rangan, Craig A. Thompson, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively. Increasing age was associated with more comorbidities (dyslipidemia, hypertension, prior coronary artery bypass graft surgery, prior stroke, peripheral arterial disease, and chronic lung disease) and more lesion calcification. As compared with the reference age of <65 years, age >75 years was independently associated with technical failure (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.20-4.28). Increasing age was also independently associated with the incidence of major adverse cardiovascular events (MACEs; OR, 2.93; 95% CI, 1.10-9.23 for 65-75 years and OR, 5.71; 95% CI, 1.89-19.60 for >75 years). Compared with men, women (n ≤ 236; 14%) were older (66.8 ± 11.1 years vs 65.0 ± 9.8 years; P≤.02), but had similar clinical characteristics and lower J-CTO scores (2.3 ± 1.3 vs 2.5 ± 1.2; P≤.02). Although crude technical success rate was higher in women compared with men (92% vs 87%; P≤.04), multivariable analysis did not show independent association between sex and technical failure (OR, men/women, 1.66; 95% CI, 0.86-3.50) or MACE (OR, 0.61; 95% CI, 0.25-1.73). CONCLUSIONS: Older age, but not sex, is associated with lower technical success and higher in-hospital complication rate for CTO-PCI. CTO-PCI is relatively infrequently attempted in women, despite high technical success and acceptable complication rates.

Original languageEnglish (US)
Pages (from-to)116-122
Number of pages7
JournalJournal of Invasive Cardiology
Volume29
Issue number4
StatePublished - Apr 1 2017

Fingerprint

Percutaneous Coronary Intervention
Odds Ratio
Confidence Intervals
Peripheral Arterial Disease
Dyslipidemias
Coronary Artery Bypass
Lung Diseases
Comorbidity
Chronic Disease
Stroke
Hypertension
Transplants
Incidence

Keywords

  • Age
  • chronic total occlusion
  • Complications
  • Outcomes
  • Percutaneous coronary intervention
  • Sex

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Karatasakis, A., Iwnetu, R., Danek, B. A., Karmpaliotis, D., Alaswad, K., Jaffer, F. A., ... Brilakis, E. S. (2017). The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention. Journal of Invasive Cardiology, 29(4), 116-122.

The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention. / Karatasakis, Aris; Iwnetu, Rahel; Danek, Barbara A.; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Jaffer, Farouc A.; Yeh, Robert W.; Kandzari, David E.; Lembo, Nicholas J.; Patel, Mitul; Mahmud, Ehtisham; Lombardi, William L.; Wyman, R. Michael; Grantham, J. Aaron; Doing, Anthony H.; Toma, Catalin; Choi, James W.; Uretsky, Barry F.; Moses, Jeffrey W.; Kirtane, Ajay J.; Ali, Ziad A.; Parikh, Manish; Karacsonyi, Judit; Rangan, Bavana V.; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.

In: Journal of Invasive Cardiology, Vol. 29, No. 4, 01.04.2017, p. 116-122.

Research output: Contribution to journalArticle

Karatasakis, A, Iwnetu, R, Danek, BA, Karmpaliotis, D, Alaswad, K, Jaffer, FA, Yeh, RW, Kandzari, DE, Lembo, NJ, Patel, M, Mahmud, E, Lombardi, WL, Wyman, RM, Grantham, JA, Doing, AH, Toma, C, Choi, JW, Uretsky, BF, Moses, JW, Kirtane, AJ, Ali, ZA, Parikh, M, Karacsonyi, J, Rangan, BV, Thompson, CA, Banerjee, S & Brilakis, ES 2017, 'The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention', Journal of Invasive Cardiology, vol. 29, no. 4, pp. 116-122.
Karatasakis A, Iwnetu R, Danek BA, Karmpaliotis D, Alaswad K, Jaffer FA et al. The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention. Journal of Invasive Cardiology. 2017 Apr 1;29(4):116-122.
Karatasakis, Aris ; Iwnetu, Rahel ; Danek, Barbara A. ; Karmpaliotis, Dimitri ; Alaswad, Khaldoon ; Jaffer, Farouc A. ; Yeh, Robert W. ; Kandzari, David E. ; Lembo, Nicholas J. ; Patel, Mitul ; Mahmud, Ehtisham ; Lombardi, William L. ; Wyman, R. Michael ; Grantham, J. Aaron ; Doing, Anthony H. ; Toma, Catalin ; Choi, James W. ; Uretsky, Barry F. ; Moses, Jeffrey W. ; Kirtane, Ajay J. ; Ali, Ziad A. ; Parikh, Manish ; Karacsonyi, Judit ; Rangan, Bavana V. ; Thompson, Craig A. ; Banerjee, Subhash ; Brilakis, Emmanouil S. / The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention. In: Journal of Invasive Cardiology. 2017 ; Vol. 29, No. 4. pp. 116-122.
@article{b5939a440e344566a11cc9332fbeb777,
title = "The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention",
abstract = "OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86{\%}) were men. Overall technical and procedural success rates were 88{\%} and 87{\%}, respectively. Increasing age was associated with more comorbidities (dyslipidemia, hypertension, prior coronary artery bypass graft surgery, prior stroke, peripheral arterial disease, and chronic lung disease) and more lesion calcification. As compared with the reference age of <65 years, age >75 years was independently associated with technical failure (odds ratio [OR], 2.28; 95{\%} confidence interval [CI], 1.20-4.28). Increasing age was also independently associated with the incidence of major adverse cardiovascular events (MACEs; OR, 2.93; 95{\%} CI, 1.10-9.23 for 65-75 years and OR, 5.71; 95{\%} CI, 1.89-19.60 for >75 years). Compared with men, women (n ≤ 236; 14{\%}) were older (66.8 ± 11.1 years vs 65.0 ± 9.8 years; P≤.02), but had similar clinical characteristics and lower J-CTO scores (2.3 ± 1.3 vs 2.5 ± 1.2; P≤.02). Although crude technical success rate was higher in women compared with men (92{\%} vs 87{\%}; P≤.04), multivariable analysis did not show independent association between sex and technical failure (OR, men/women, 1.66; 95{\%} CI, 0.86-3.50) or MACE (OR, 0.61; 95{\%} CI, 0.25-1.73). CONCLUSIONS: Older age, but not sex, is associated with lower technical success and higher in-hospital complication rate for CTO-PCI. CTO-PCI is relatively infrequently attempted in women, despite high technical success and acceptable complication rates.",
keywords = "Age, chronic total occlusion, Complications, Outcomes, Percutaneous coronary intervention, Sex",
author = "Aris Karatasakis and Rahel Iwnetu and Danek, {Barbara A.} and Dimitri Karmpaliotis and Khaldoon Alaswad and Jaffer, {Farouc A.} and Yeh, {Robert W.} and Kandzari, {David E.} and Lembo, {Nicholas J.} and Mitul Patel and Ehtisham Mahmud and Lombardi, {William L.} and Wyman, {R. Michael} and Grantham, {J. Aaron} and Doing, {Anthony H.} and Catalin Toma and Choi, {James W.} and Uretsky, {Barry F.} and Moses, {Jeffrey W.} and Kirtane, {Ajay J.} and Ali, {Ziad A.} and Manish Parikh and Judit Karacsonyi and Rangan, {Bavana V.} and Thompson, {Craig A.} and Subhash Banerjee and Brilakis, {Emmanouil S.}",
year = "2017",
month = "4",
day = "1",
language = "English (US)",
volume = "29",
pages = "116--122",
journal = "Journal of Invasive Cardiology",
issn = "1042-3931",
publisher = "HMP Communications",
number = "4",

}

TY - JOUR

T1 - The Impact of Age and Sex on In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention

AU - Karatasakis, Aris

AU - Iwnetu, Rahel

AU - Danek, Barbara A.

AU - Karmpaliotis, Dimitri

AU - Alaswad, Khaldoon

AU - Jaffer, Farouc A.

AU - Yeh, Robert W.

AU - Kandzari, David E.

AU - Lembo, Nicholas J.

AU - Patel, Mitul

AU - Mahmud, Ehtisham

AU - Lombardi, William L.

AU - Wyman, R. Michael

AU - Grantham, J. Aaron

AU - Doing, Anthony H.

AU - Toma, Catalin

AU - Choi, James W.

AU - Uretsky, Barry F.

AU - Moses, Jeffrey W.

AU - Kirtane, Ajay J.

AU - Ali, Ziad A.

AU - Parikh, Manish

AU - Karacsonyi, Judit

AU - Rangan, Bavana V.

AU - Thompson, Craig A.

AU - Banerjee, Subhash

AU - Brilakis, Emmanouil S.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively. Increasing age was associated with more comorbidities (dyslipidemia, hypertension, prior coronary artery bypass graft surgery, prior stroke, peripheral arterial disease, and chronic lung disease) and more lesion calcification. As compared with the reference age of <65 years, age >75 years was independently associated with technical failure (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.20-4.28). Increasing age was also independently associated with the incidence of major adverse cardiovascular events (MACEs; OR, 2.93; 95% CI, 1.10-9.23 for 65-75 years and OR, 5.71; 95% CI, 1.89-19.60 for >75 years). Compared with men, women (n ≤ 236; 14%) were older (66.8 ± 11.1 years vs 65.0 ± 9.8 years; P≤.02), but had similar clinical characteristics and lower J-CTO scores (2.3 ± 1.3 vs 2.5 ± 1.2; P≤.02). Although crude technical success rate was higher in women compared with men (92% vs 87%; P≤.04), multivariable analysis did not show independent association between sex and technical failure (OR, men/women, 1.66; 95% CI, 0.86-3.50) or MACE (OR, 0.61; 95% CI, 0.25-1.73). CONCLUSIONS: Older age, but not sex, is associated with lower technical success and higher in-hospital complication rate for CTO-PCI. CTO-PCI is relatively infrequently attempted in women, despite high technical success and acceptable complication rates.

AB - OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively. Increasing age was associated with more comorbidities (dyslipidemia, hypertension, prior coronary artery bypass graft surgery, prior stroke, peripheral arterial disease, and chronic lung disease) and more lesion calcification. As compared with the reference age of <65 years, age >75 years was independently associated with technical failure (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.20-4.28). Increasing age was also independently associated with the incidence of major adverse cardiovascular events (MACEs; OR, 2.93; 95% CI, 1.10-9.23 for 65-75 years and OR, 5.71; 95% CI, 1.89-19.60 for >75 years). Compared with men, women (n ≤ 236; 14%) were older (66.8 ± 11.1 years vs 65.0 ± 9.8 years; P≤.02), but had similar clinical characteristics and lower J-CTO scores (2.3 ± 1.3 vs 2.5 ± 1.2; P≤.02). Although crude technical success rate was higher in women compared with men (92% vs 87%; P≤.04), multivariable analysis did not show independent association between sex and technical failure (OR, men/women, 1.66; 95% CI, 0.86-3.50) or MACE (OR, 0.61; 95% CI, 0.25-1.73). CONCLUSIONS: Older age, but not sex, is associated with lower technical success and higher in-hospital complication rate for CTO-PCI. CTO-PCI is relatively infrequently attempted in women, despite high technical success and acceptable complication rates.

KW - Age

KW - chronic total occlusion

KW - Complications

KW - Outcomes

KW - Percutaneous coronary intervention

KW - Sex

UR - http://www.scopus.com/inward/record.url?scp=85017219364&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017219364&partnerID=8YFLogxK

M3 - Article

C2 - 28089997

AN - SCOPUS:85017219364

VL - 29

SP - 116

EP - 122

JO - Journal of Invasive Cardiology

JF - Journal of Invasive Cardiology

SN - 1042-3931

IS - 4

ER -