Coronary chronic total occlusion in the elderly: Demographic inevitability, treatment uncertainty

摘要

The process of "demographic transition," long-observed by sociologists and historians, is characterized by a series of changes in populations that culminate in their aging over time (1). In the field of cardiology, the transition has been catalyzed by dramatic improvements in primary and secondary prevention and has resulted in profound shifts in the epidemiology of coronary artery disease (CAD) (2). One manifestation of these shifts is that members of the growing elderly population now present with symptomatic CAD later in life. Unfortunately, the evidence basis supporting treatment decisions in the elderly has not kept pace with this expanding clinical need.