TY - JOUR
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
N1 - Publisher Copyright:
© 2017 American College of Cardiology Foundation
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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U2 - 10.1016/j.jcin.2017.05.065
DO - 10.1016/j.jcin.2017.05.065
M3 - Article
C2 - 28797429
AN - SCOPUS:85027557723
SN - 1936-8798
VL - 10
SP - 1523
EP - 1534
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 15
ER -