TY - JOUR
T1 - Follow-up outcomes after chronic total occlusion percutaneous coronary intervention in patients with and without prior coronary artery bypass graft surgery
T2 - Insights from the progress-cto registry
AU - Nikolakopoulos, Ilias
AU - Choi, James W.
AU - Khatri, Jaikirshan J.
AU - Alaswad, Khaldoon
AU - Doing, Anthony H.
AU - Dattilo, Phil
AU - Rafeh, Nidal Abi
AU - Maalouf, Assaad
AU - Jaoudeh, Fadi Abou
AU - Tamez, Hector
AU - Shah, Alpesh
AU - Gkargkoulas, Fotis
AU - Lembo, Nicholas J.
AU - Parikh, Manish
AU - Kirtane, Ajay J.
AU - Ali, Ziad A.
AU - Vemmou, Evangelia
AU - Xenogiannis, Iosif
AU - Rangan, Bavana Venkata
AU - Abdullah, Shuaib
AU - Banerjee, Subhash
AU - Garcia, Santiago
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
AU - Karmpaliotis, Dimitri
N1 - Publisher Copyright:
© 2020 HMP Communications. All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - 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.
AB - 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.
KW - Chronic total occlusion
KW - Coronary artery bypass graft surgery
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M3 - Article
C2 - 32428867
AN - SCOPUS:85089126071
SN - 1042-3931
VL - 32
SP - 315
EP - 320
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 8
ER -