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In addition, in the elderly, the likelihood of severe and diffuse CAD is higher than in younger populations[24]. Moreover, due to higher rates of procedure-related complications[25,26] and a lack of clinical trials comparing treatments in patients older than 65 years, the treatment of this specific population becomes even more challenging. A sub analysis from the CASS registry[27] showed that in 1985 older CAD patients surgically treated had better survival rates compared to medically treated patients, during a 6-year follow-up (adjusted 6-year survival 79% and 64%, respectively, for surgical and medical therapy groups, P Ribonuclease T1 published in 2002 analyzed clinical data and outcomes of all patients who underwent catheterization and revascularization in the province of Alberta, Canada[28]. This study showed that in 3 age cohorts (Streptozotocin chemical structure years), CABG was superior to PCI and medical therapy alone in terms of overall survival during 4-year follow-up. However, this study has also to be analyzed carefully because its design was observational, non-randomized, and included a great range of risk profiles, such as acute coronary syndrome patients as well as patients with impaired ventricular function, which may have favored surgical results. One of the few studies designed to compare a conservative vs an invasive strategy for the treatment of elderly CAD patients learn more was the Trial of Invasive vs Medical therapy in Elderly patients (TIME), published in 2004[29]. In this study, patients age 75 years or older, with Canadian Cardiac Society (CCS) class II or greater angina, despite taking at least 2 classes of anti-anginal drugs, were randomized to medical therapy alone or to angiography and appropriate coronary revascularization (PCI or CABG). Despite their high-risk profile (mean age at entry 80-year-old, 82% with CCS class III or IV angina), survival was similar between patients in the two strategies (91.5% vs 95.9% after 6 mo, 89.5% vs 93.9% after 1 year, and 70.6% vs 73.0% after 4.1 years, respectively, for medical therapy and revascularization strategies, P = NS). However, late revascularizations were more frequent in the medical therapy than in the revascularization group (45% vs 12%, P