Copyright © 2004 by the European Society of Cardiology.
Clinical research
Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina – on-treatment analysis of the TIME trial
a Department of Cardiology, University Hospitals Basel, Petersgraben 4, 4031 Basel, Switzerland
b Kantonsspital, Lucern, Switzerland
c University Hospital, Zürich, Switzerland
d Triemli Spital, Zürich, Switzerland
e Kantonsspital, Biel, Switzerland
f Institute of Social and Preventive Medicine, University of Basel, Switzerland
* Corresponding author. Tel.: +41-61-265-52-13/14; fax: +41-61-265-45-98
E-mail address: pfisterer{at}email.ch
Received 3 December 2003; accepted 4 February 2004
Abstract
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 
: 112 randomised to revascularisation and 62 to drugs with late revascularisation) were compared to all patients on continued drug therapy (MED 
: 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; 
) and of death/infarction (adjusted hazard ratio=1.77; 95%-CI 0.91–3.41; 
) 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; 
. Overall, REVASC patients had greater improvements in symptoms and well-being than MED patients 
. Surgical patients had similar mortality rates as angioplasty patients, but they also had greater symptomatic improvements .
Conclusion Treated medically, elderly patients with chronic angina have a similarly high 30-day and one-year mortality as patients of the same age being re-vascularised; however, they can expect lower improvements in symptoms and well being.
Key Words: Aging • Angina • Coronary disease • Mortality • Quality of life • Revascularisation
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