Early Procedural and Health Status Outcomes After Chronic Total Occlusion Angioplasty: A Report From the OPEN-CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures)

James Sapontis, Adam C. Salisbury, Robert W. Yeh, David J. Cohen, Taishi Hirai, William Lombardi, James M. McCabe, Dimitri Karmpaliotis, Jeffrey Moses, William J. Nicholson, Ashish Pershad, R. Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R. Thompson, Steven P. Marso, Karen Nugent, Kensey GoschJohn A. Spertus, J. Aaron Grantham

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Objectives This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. Methods Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients. Results Technical success was high (86%). In-hospital and 1-month mortality was 0.9% and 1.3%, respectively, and perforations requiring treatment occurred in 48 patients (4.8%). Among those who survived and completed the 1-month interview (n = 947), mean ± SEM Seattle Angina Questionnaire quality of life scores improved from 49.4 ± 0.9 to 75.0 ± 0.7 (p < 0.01), mean Rose Dyspnea Scale scores improved (decreased) from 2.0 ± 0.1 to 1.1 ± 0.1 (p < 0.01), and physician health questionnaire (for depression) scores improved (decreased) from 6.2 ± 0.2 to 3.5 ± 0.1 (p < 0.01) at 1 month. After adjusting for baseline differences the mean group difference in Seattle Angina Questionnaire quality of life between successful and unsuccessful CTO PCI was 10.8 (95% confidence interval: 6.3 to 15.3; p < 0.001). Conclusions Clarifying the success rates, risks, and benefits of CTO PCI will help to more accurately contextualize the informed consent process for these procedures so that patients with appropriate indications for CTO PCI can more effectively share in the decision to pursue this or other therapeutic options.

Original languageEnglish (US)
Pages (from-to)1523-1534
Number of pages12
JournalJACC: Cardiovascular Interventions
Volume10
Issue number15
DOIs
StatePublished - Aug 14 2017

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Percutaneous Coronary Intervention
Health Status
Registries
Quality of Life
Insurance Benefits
Informed Consent
Dyspnea
Confidence Intervals
Interviews
Physicians
Mortality
Health
Therapeutics
Surveys and Questionnaires

Keywords

  • angioplasty
  • chronic total occlusion
  • coronary artery disease
  • quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Early Procedural and Health Status Outcomes After Chronic Total Occlusion Angioplasty : A Report From the OPEN-CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures). / Sapontis, James; Salisbury, Adam C.; Yeh, Robert W.; Cohen, David J.; Hirai, Taishi; Lombardi, William; McCabe, James M.; Karmpaliotis, Dimitri; Moses, Jeffrey; Nicholson, William J.; Pershad, Ashish; Wyman, R. Michael; Spaedy, Anthony; Cook, Stephen; Doshi, Parag; Federici, Robert; Thompson, Craig R.; Marso, Steven P.; Nugent, Karen; Gosch, Kensey; Spertus, John A.; Grantham, J. Aaron.

In: JACC: Cardiovascular Interventions, Vol. 10, No. 15, 14.08.2017, p. 1523-1534.

Research output: Contribution to journalArticle

Sapontis, J, Salisbury, AC, Yeh, RW, Cohen, DJ, Hirai, T, Lombardi, W, McCabe, JM, Karmpaliotis, D, Moses, J, Nicholson, WJ, Pershad, A, Wyman, RM, Spaedy, A, Cook, S, Doshi, P, Federici, R, Thompson, CR, Marso, SP, Nugent, K, Gosch, K, Spertus, JA & Grantham, JA 2017, 'Early Procedural and Health Status Outcomes After Chronic Total Occlusion Angioplasty: A Report From the OPEN-CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures)', JACC: Cardiovascular Interventions, vol. 10, no. 15, pp. 1523-1534. https://doi.org/10.1016/j.jcin.2017.05.065
Sapontis, James ; Salisbury, Adam C. ; Yeh, Robert W. ; Cohen, David J. ; Hirai, Taishi ; Lombardi, William ; McCabe, James M. ; Karmpaliotis, Dimitri ; Moses, Jeffrey ; Nicholson, William J. ; Pershad, Ashish ; Wyman, R. Michael ; Spaedy, Anthony ; Cook, Stephen ; Doshi, Parag ; Federici, Robert ; Thompson, Craig R. ; Marso, Steven P. ; Nugent, Karen ; Gosch, Kensey ; Spertus, John A. ; Grantham, J. Aaron. / Early Procedural and Health Status Outcomes After Chronic Total Occlusion Angioplasty : A Report From the OPEN-CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures). In: JACC: Cardiovascular Interventions. 2017 ; Vol. 10, No. 15. pp. 1523-1534.
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abstract = "Objectives This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. Methods Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients. Results Technical success was high (86{\%}). In-hospital and 1-month mortality was 0.9{\%} and 1.3{\%}, respectively, and perforations requiring treatment occurred in 48 patients (4.8{\%}). Among those who survived and completed the 1-month interview (n = 947), mean ± SEM Seattle Angina Questionnaire quality of life scores improved from 49.4 ± 0.9 to 75.0 ± 0.7 (p < 0.01), mean Rose Dyspnea Scale scores improved (decreased) from 2.0 ± 0.1 to 1.1 ± 0.1 (p < 0.01), and physician health questionnaire (for depression) scores improved (decreased) from 6.2 ± 0.2 to 3.5 ± 0.1 (p < 0.01) at 1 month. After adjusting for baseline differences the mean group difference in Seattle Angina Questionnaire quality of life between successful and unsuccessful CTO PCI was 10.8 (95{\%} confidence interval: 6.3 to 15.3; p < 0.001). Conclusions Clarifying the success rates, risks, and benefits of CTO PCI will help to more accurately contextualize the informed consent process for these procedures so that patients with appropriate indications for CTO PCI can more effectively share in the decision to pursue this or other therapeutic options.",
keywords = "angioplasty, chronic total occlusion, coronary artery disease, quality of life",
author = "James Sapontis and Salisbury, {Adam C.} and Yeh, {Robert W.} and Cohen, {David J.} and Taishi Hirai and William Lombardi and McCabe, {James M.} and Dimitri Karmpaliotis and Jeffrey Moses and Nicholson, {William J.} and Ashish Pershad and Wyman, {R. Michael} and Anthony Spaedy and Stephen Cook and Parag Doshi and Robert Federici and Thompson, {Craig R.} and Marso, {Steven P.} and Karen Nugent and Kensey Gosch and Spertus, {John A.} and Grantham, {J. Aaron}",
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T1 - Early Procedural and Health Status Outcomes After Chronic Total Occlusion Angioplasty

T2 - A Report From the OPEN-CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures)

AU - Sapontis, James

AU - Salisbury, Adam C.

AU - Yeh, Robert W.

AU - Cohen, David J.

AU - Hirai, Taishi

AU - Lombardi, William

AU - McCabe, James M.

AU - Karmpaliotis, Dimitri

AU - Moses, Jeffrey

AU - Nicholson, William J.

AU - Pershad, Ashish

AU - Wyman, R. Michael

AU - Spaedy, Anthony

AU - Cook, Stephen

AU - Doshi, Parag

AU - Federici, Robert

AU - Thompson, Craig R.

AU - Marso, Steven P.

AU - Nugent, Karen

AU - Gosch, Kensey

AU - Spertus, John A.

AU - Grantham, J. Aaron

PY - 2017/8/14

Y1 - 2017/8/14

N2 - Objectives This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. Methods Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients. Results Technical success was high (86%). In-hospital and 1-month mortality was 0.9% and 1.3%, respectively, and perforations requiring treatment occurred in 48 patients (4.8%). Among those who survived and completed the 1-month interview (n = 947), mean ± SEM Seattle Angina Questionnaire quality of life scores improved from 49.4 ± 0.9 to 75.0 ± 0.7 (p < 0.01), mean Rose Dyspnea Scale scores improved (decreased) from 2.0 ± 0.1 to 1.1 ± 0.1 (p < 0.01), and physician health questionnaire (for depression) scores improved (decreased) from 6.2 ± 0.2 to 3.5 ± 0.1 (p < 0.01) at 1 month. After adjusting for baseline differences the mean group difference in Seattle Angina Questionnaire quality of life between successful and unsuccessful CTO PCI was 10.8 (95% confidence interval: 6.3 to 15.3; p < 0.001). Conclusions Clarifying the success rates, risks, and benefits of CTO PCI will help to more accurately contextualize the informed consent process for these procedures so that patients with appropriate indications for CTO PCI can more effectively share in the decision to pursue this or other therapeutic options.

AB - Objectives This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Background In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. Methods Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients. Results Technical success was high (86%). In-hospital and 1-month mortality was 0.9% and 1.3%, respectively, and perforations requiring treatment occurred in 48 patients (4.8%). Among those who survived and completed the 1-month interview (n = 947), mean ± SEM Seattle Angina Questionnaire quality of life scores improved from 49.4 ± 0.9 to 75.0 ± 0.7 (p < 0.01), mean Rose Dyspnea Scale scores improved (decreased) from 2.0 ± 0.1 to 1.1 ± 0.1 (p < 0.01), and physician health questionnaire (for depression) scores improved (decreased) from 6.2 ± 0.2 to 3.5 ± 0.1 (p < 0.01) at 1 month. After adjusting for baseline differences the mean group difference in Seattle Angina Questionnaire quality of life between successful and unsuccessful CTO PCI was 10.8 (95% confidence interval: 6.3 to 15.3; p < 0.001). Conclusions Clarifying the success rates, risks, and benefits of CTO PCI will help to more accurately contextualize the informed consent process for these procedures so that patients with appropriate indications for CTO PCI can more effectively share in the decision to pursue this or other therapeutic options.

KW - angioplasty

KW - chronic total occlusion

KW - coronary artery disease

KW - quality of life

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