TY - JOUR
T1 - Impact of Successful Chronic Total Occlusion Percutaneous Coronary Interventions on Subsequent Clinical Outcomes
AU - Xenogiannis, Iosif
AU - Nikolakopoulos, Ilias
AU - Krestyaninov, Oleg
AU - Khelimskii, Dmitrii
AU - Khatri, Jaikirshan J.
AU - Doing, Anthony H.
AU - Dattilo, Phil
AU - Alaswad, Khaldoon
AU - Toma, Catalin
AU - Sheikh, Abdul M.
AU - Jaffer, Farouc A.
AU - Jefferson, Brian K.
AU - Patel, Taral
AU - Chandwaney, Raj H.
AU - Jaber, Wissam
AU - Samady, Habib
AU - Patel, Mitul
AU - Mahmud, Ehtisham
AU - Choi, James
AU - Koutouzis, Michalis
AU - Tsiafoutis, Ioannis
AU - Megaly, Michael
AU - Omer, Mohamed
AU - Vemmou, Evangelia
AU - Rangan, Bavana V.
AU - Garcia, Santiago
AU - Abdullah, Shuaib
AU - Banerjee, Subhash
AU - Burke, Nicholas
AU - Brilakis, Emmanouil S.
AU - Karmpaliotis, Dimitri
N1 - Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2020/11/1
Y1 - 2020/11/1
N2 - BACKGROUND: The impact of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on angina and subsequent incidence of major adverse cardiovascular event (MACE) rate remains controversial. METHODS: We compared patient- reported angina change and the incidence of MACE (defined as death, myocardial infarction [MI], target-vessel revascularization) between successful vs failed CTO-PCI in 1612 patients participating in a large, multicenter registry. RESULTS: CTO-PCI was successful in 1387 patients (86%). Compared with failed CTO-PCI, successful CTO-PCI patients were less likely to have history of heart failure (33% vs 41%; P=.02), prior MI (49% vs 62%; P<.01), or prior coronary revascularization (63% vs 71% [P=.03] for PCI and 30% vs 40% [P<.01] for coronary artery bypass graft surgery). Patients in the successful CTO-PCI group had lower J-CTO scores (2.4 ± 1.3 vs 3.1 ± 1.1; P<.01) and lower PROGRESS-CTO Complications scores (1.1 ± 1.0 vs 1.6 ± 1.0; P<.01). After a mean follow-up of 181 ± 153 days, patients with successful PCI were more likely to have angina improvement (83% vs 38%; P<.01) and had lower incidence of 1-year MACE (8% vs 15%; P<.01), death (3% vs 7%; P<.01), and MI (2% vs 4%; P=.02). On multivariable analysis, however, CTO-PCI success was not independently associated with MACE. CONCLUSION: Compared with failed CTO-PCI, successful CTO-PCI is associated with better angina improvement and lower incidence of MACE (on univariable analysis) during follow-up.
AB - BACKGROUND: The impact of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on angina and subsequent incidence of major adverse cardiovascular event (MACE) rate remains controversial. METHODS: We compared patient- reported angina change and the incidence of MACE (defined as death, myocardial infarction [MI], target-vessel revascularization) between successful vs failed CTO-PCI in 1612 patients participating in a large, multicenter registry. RESULTS: CTO-PCI was successful in 1387 patients (86%). Compared with failed CTO-PCI, successful CTO-PCI patients were less likely to have history of heart failure (33% vs 41%; P=.02), prior MI (49% vs 62%; P<.01), or prior coronary revascularization (63% vs 71% [P=.03] for PCI and 30% vs 40% [P<.01] for coronary artery bypass graft surgery). Patients in the successful CTO-PCI group had lower J-CTO scores (2.4 ± 1.3 vs 3.1 ± 1.1; P<.01) and lower PROGRESS-CTO Complications scores (1.1 ± 1.0 vs 1.6 ± 1.0; P<.01). After a mean follow-up of 181 ± 153 days, patients with successful PCI were more likely to have angina improvement (83% vs 38%; P<.01) and had lower incidence of 1-year MACE (8% vs 15%; P<.01), death (3% vs 7%; P<.01), and MI (2% vs 4%; P=.02). On multivariable analysis, however, CTO-PCI success was not independently associated with MACE. CONCLUSION: Compared with failed CTO-PCI, successful CTO-PCI is associated with better angina improvement and lower incidence of MACE (on univariable analysis) during follow-up.
KW - chronic total occlusion
KW - follow-up
KW - major adverse cardiovascular events
KW - percutaneous coronary intervention
KW - symptom improvement
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M3 - Article
C2 - 32568095
AN - SCOPUS:85094983195
SN - 1042-3931
VL - 32
SP - 433
EP - 439
JO - The Journal of invasive cardiology
JF - The Journal of invasive cardiology
IS - 11
ER -