Follow-up outcomes after chronic total occlusion percutaneous coronary intervention in patients with and without prior coronary artery bypass graft surgery: Insights from the progress-cto registry

Ilias Nikolakopoulos, James W. Choi, Jaikirshan J. Khatri, Khaldoon Alaswad, Anthony H. Doing, Phil Dattilo, Nidal Abi Rafeh, Assaad Maalouf, Fadi Abou Jaoudeh, Hector Tamez, Alpesh Shah, Fotis Gkargkoulas, Nicholas J. Lembo, Manish Parikh, Ajay J. Kirtane, Ziad A. Ali, Evangelia Vemmou, Iosif Xenogiannis, Bavana V. Rangan, Shuaib AbdullahSubhash Banerjee, Santiago Garcia, M. Nicholas Burke, Emmanouil S. Brilakis, Dimitri Karmpaliotis

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Long-term outcomes of patients with prior coronary artery bypass graft (CABG) surgery undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have received limited study. Methods. We compared the clinical and angiographic characteristics and procedural and follow-up outcomes of patients with and without prior CABG in a multicenter international registry. Results. Of the 1572 patients included in this analysis, a total of 498 (32%) had prior CABG. Prior CABG patients had higher J-CTO scores (2.9 ± 1.1 vs 2.2 ± 1.3, P<.001) and were less likely to undergo PCI of the left anterior descending artery (16.7% vs 29.6%, P<.001). The retrograde technique was used more often (47.4% vs 28.2%, P<.001) and was successful more often (27.4% vs 17.1%, P<.001) in the prior CABG group vs the non-prior CABG group. Technical success was lower in prior CABG patients (82.6% vs 87.9%, P<.01) with similar incidence of in-hospital major adverse cardiovascular events (3.4% vs 3%, P=.65), although in-hospital mortality was higher in the prior CABG group (2.4% vs 1.0%, P=.04). At 1-year follow-up, the composite endpoint of death, myocardial infarction, and revascularization was higher in prior CABG patients (21.79% vs 12.73%, hazard ratio, 1.76, 95% confidence interval, 1.27-2.45, P<.001). Conclusion. Compared with non-prior CABG patients, prior CABG patients undergoing CTO-PCI had lower technical success and higher incidence of acute and follow-up adverse cardiovascular events. J INVASIVE CARDIOL 2020,32(8):315-320. Epub 2020 May 20.

Original languageEnglish (US)
Pages (from-to)315-320
Number of pages6
JournalJournal of Invasive Cardiology
Volume32
Issue number8
StatePublished - Aug 2020

Keywords

  • Chronic total occlusion
  • Coronary artery bypass graft surgery

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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