Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina – on-treatment analysis of the TIME trial

• Published in: European heart journal 2004-06, Vol.25 (12), p.1036-1042
• Main Authors: Kaiser, Christoph, Kuster, Gabriela M., Erne, Paul, Amann, Wolfgang, Naegeli, Barbara, Osswald, Stefan, Buser, Peter, Schläpfer, Heinz, Brett, Wolfgang, Zerkowski, Hans-Reinhard, Schindler, Christian, Pfisterer, Matthias
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Angina; Angina Pectoris - mortality; Angina Pectoris - therapy; Angioplasty, Balloon - mortality; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular Agents - therapeutic use; Combined Modality Therapy; Coronary Artery Bypass - mortality; Coronary disease; Coronary heart disease; Female; Heart; Humans; Male; Medical sciences; Mortality; Myocardial Revascularization - methods; Myocardial Revascularization - mortality; Proportional Hazards Models; Prospective Studies; Quality of Life; Revascularisation; Risk Factors; Survival Analysis; Treatment Outcome
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1016/j.ehj.2004.02.033

Aim To assess treatment effects of optimised medical therapy and PCI or CABG surgery on one-year outcome in patients ⩾75 years old with chronic angina. Methods and Results On-treatment analysis of the TIME data: all re-vascularised patients (REVASC \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(n=174\) \end{document}: 112 randomised to revascularisation and 62 to drugs with late revascularisation) were compared to all patients on continued drug therapy (MED \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(n=127\) \end{document}: 86 randomised to drugs and 41 to revascularisation only). Baseline characteristics of both groups were similar (age 80±4 years). Risk of death at one year (adjusted hazard ratio (HR)=1.31; 95%-CI: 0.58–2.99; \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(P=0.52\) \end{document}) and of death/infarction (adjusted hazard ratio=1.77; 95%-CI 0.91–3.41; \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(P=0.09\) \end{document}) were comparable between REVASC and MED patients. Furthermore, the risk of death within 30 days was even slightly lower among REVASC patients (unadjusted hazard ratio=0.73; 95%-CI: 0.21–2.53; \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(P=0.98)\) \end{document}. Overall, REVASC patients had greater improvements in symptoms and well-being than MED patients \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \((P{