Dallas, TX - Rates of long-term survival, relief from angina, and improvements in quality of life in the elderly are similar, regardless of whether they are initially treated using an invasive strategy (PCI or CABG) or medication. Such were the conclusions of an extended follow-up of the Trial of Invasive versus Medical Therapy in Elderly Patients (TIME), appearing online in Circulation this week.1

The original TIME results were first presented at the 2002 European Society of Cardiology meeting by Dr Matthias Pfisterer (Medical Clinic 1, Basel, Switzerland), as reported by heartwire. The original study compared the two treatment strategies over a six-month period. Now, in a new analysis, Pfisterer et al looked at all TIME participants who had survived to one year and tracked their survival over an additional three years.

They report that survival in both treatment groups was not statistically different at one year or at four years postrandomization. Factors that increased mortality in both groups included age >80 at baseline, prior heart failure, reduced LV function, two or more comorbidities, and no revascularization within the first year.

Nonfatal events, primarily repeat hospitalizations, were more common in the medically treated patients, although this difference decreased with time, in part because 46% of patients initially randomized to medical management went on to have a revascularization procedure within the first year. The early benefit of both treatments in angina relief and quality of life was maintained long term, the authors add.