Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients Who Have Undergone Coronary Artery Bypass Grafting vs Those Who Have Not

Lorenzo Azzalini, Soledad Ojeda, Aris Karatasakis, Joren Maeremans, Masaki Tanabe, Alessio La Manna, Rustem Dautov, Luiz F. Ybarra, Susanna Benincasa, Barbara Bellini, Luciano Candilio, Ozan M. Demir, Francisco Hidalgo, Judit Karacsonyi, Giacomo Gravina, Eligio Miccichè, Guido D'Agosta, Giuseppe Venuti, Corrado Tamburino, Manuel PanMauro Carlino, Joseph Dens, Emmanouil S. Brilakis, Antonio Colombo, Stéphane Rinfret

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in Fr. ance, the Nethe. rlands, Bel. gium, and Unit. ed Kingdom (RECHARGE) score in predicting acute and long-term outcomes. Methods: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017. The primary end point was target-vessel failure (TVF), a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization on follow-up. Results: Overall, 2058 patients were included (patients who underwent CABG, n = 401; CABG-naïve patients, n = 1657). Patients who had undergone CABG were older and had a higher prevalence of comorbidities and higher occlusion complexity (RECHARGE score, 3.6 ± 1.3 vs 1.8 ± 1.2; P < 0.001). Antegrade dissection/re-entry techniques and the retrograde approach were used more frequently in patients who had undergone CABG. Procedural metrics were worse, and technical (82% vs 88%; P = 0.001) and procedural (81% vs 87%; P = 0.001) success was lower in patients who had undergone CABG. They also experienced a higher rate of major complications (3.7% vs 1.5%; P = 0.004). The RECHARGE score was inversely associated with technical success (P < 0.001). Median follow-up was 377 days (interquartile range, 277-766 days). The 24-month TVF rate was higher in patients who had undergone CABG than in CABG-naïve patients (16.1% vs 9.0%; P < 0.001). On multivariable analysis, the RECHARGE score (hazard ratio, 1.61; P < 0.001) remained an independent predictor of TVF, together with longer total stent length and not using a drug-eluting stent. Conclusions: Compared with CABG-naïve patients, CTO PCI in patients who had undergone CABG shows higher procedural complexity, worse success rates, and higher adjusted risk of TVF on follow-up.

Original languageEnglish (US)
JournalCanadian Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Percutaneous Coronary Intervention
Coronary Artery Bypass
Registries
Drug-Eluting Stents
Stents
Dissection
Comorbidity
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients Who Have Undergone Coronary Artery Bypass Grafting vs Those Who Have Not. / Azzalini, Lorenzo; Ojeda, Soledad; Karatasakis, Aris; Maeremans, Joren; Tanabe, Masaki; La Manna, Alessio; Dautov, Rustem; Ybarra, Luiz F.; Benincasa, Susanna; Bellini, Barbara; Candilio, Luciano; Demir, Ozan M.; Hidalgo, Francisco; Karacsonyi, Judit; Gravina, Giacomo; Miccichè, Eligio; D'Agosta, Guido; Venuti, Giuseppe; Tamburino, Corrado; Pan, Manuel; Carlino, Mauro; Dens, Joseph; Brilakis, Emmanouil S.; Colombo, Antonio; Rinfret, Stéphane.

In: Canadian Journal of Cardiology, 01.01.2018.

Research output: Contribution to journalArticle

Azzalini, L, Ojeda, S, Karatasakis, A, Maeremans, J, Tanabe, M, La Manna, A, Dautov, R, Ybarra, LF, Benincasa, S, Bellini, B, Candilio, L, Demir, OM, Hidalgo, F, Karacsonyi, J, Gravina, G, Miccichè, E, D'Agosta, G, Venuti, G, Tamburino, C, Pan, M, Carlino, M, Dens, J, Brilakis, ES, Colombo, A & Rinfret, S 2018, 'Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients Who Have Undergone Coronary Artery Bypass Grafting vs Those Who Have Not', Canadian Journal of Cardiology. https://doi.org/10.1016/j.cjca.2017.12.016
Azzalini, Lorenzo ; Ojeda, Soledad ; Karatasakis, Aris ; Maeremans, Joren ; Tanabe, Masaki ; La Manna, Alessio ; Dautov, Rustem ; Ybarra, Luiz F. ; Benincasa, Susanna ; Bellini, Barbara ; Candilio, Luciano ; Demir, Ozan M. ; Hidalgo, Francisco ; Karacsonyi, Judit ; Gravina, Giacomo ; Miccichè, Eligio ; D'Agosta, Guido ; Venuti, Giuseppe ; Tamburino, Corrado ; Pan, Manuel ; Carlino, Mauro ; Dens, Joseph ; Brilakis, Emmanouil S. ; Colombo, Antonio ; Rinfret, Stéphane. / Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients Who Have Undergone Coronary Artery Bypass Grafting vs Those Who Have Not. In: Canadian Journal of Cardiology. 2018.
@article{eeefcc498a904756b247b334a1b26249,
title = "Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients Who Have Undergone Coronary Artery Bypass Grafting vs Those Who Have Not",
abstract = "Background: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in Fr. ance, the Nethe. rlands, Bel. gium, and Unit. ed Kingdom (RECHARGE) score in predicting acute and long-term outcomes. Methods: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017. The primary end point was target-vessel failure (TVF), a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization on follow-up. Results: Overall, 2058 patients were included (patients who underwent CABG, n = 401; CABG-na{\"i}ve patients, n = 1657). Patients who had undergone CABG were older and had a higher prevalence of comorbidities and higher occlusion complexity (RECHARGE score, 3.6 ± 1.3 vs 1.8 ± 1.2; P < 0.001). Antegrade dissection/re-entry techniques and the retrograde approach were used more frequently in patients who had undergone CABG. Procedural metrics were worse, and technical (82{\%} vs 88{\%}; P = 0.001) and procedural (81{\%} vs 87{\%}; P = 0.001) success was lower in patients who had undergone CABG. They also experienced a higher rate of major complications (3.7{\%} vs 1.5{\%}; P = 0.004). The RECHARGE score was inversely associated with technical success (P < 0.001). Median follow-up was 377 days (interquartile range, 277-766 days). The 24-month TVF rate was higher in patients who had undergone CABG than in CABG-na{\"i}ve patients (16.1{\%} vs 9.0{\%}; P < 0.001). On multivariable analysis, the RECHARGE score (hazard ratio, 1.61; P < 0.001) remained an independent predictor of TVF, together with longer total stent length and not using a drug-eluting stent. Conclusions: Compared with CABG-na{\"i}ve patients, CTO PCI in patients who had undergone CABG shows higher procedural complexity, worse success rates, and higher adjusted risk of TVF on follow-up.",
author = "Lorenzo Azzalini and Soledad Ojeda and Aris Karatasakis and Joren Maeremans and Masaki Tanabe and {La Manna}, Alessio and Rustem Dautov and Ybarra, {Luiz F.} and Susanna Benincasa and Barbara Bellini and Luciano Candilio and Demir, {Ozan M.} and Francisco Hidalgo and Judit Karacsonyi and Giacomo Gravina and Eligio Miccich{\`e} and Guido D'Agosta and Giuseppe Venuti and Corrado Tamburino and Manuel Pan and Mauro Carlino and Joseph Dens and Brilakis, {Emmanouil S.} and Antonio Colombo and St{\'e}phane Rinfret",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.cjca.2017.12.016",
language = "English (US)",
journal = "Canadian Journal of Cardiology",
issn = "0828-282X",
publisher = "Pulsus Group Inc.",

}

TY - JOUR

T1 - Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients Who Have Undergone Coronary Artery Bypass Grafting vs Those Who Have Not

AU - Azzalini, Lorenzo

AU - Ojeda, Soledad

AU - Karatasakis, Aris

AU - Maeremans, Joren

AU - Tanabe, Masaki

AU - La Manna, Alessio

AU - Dautov, Rustem

AU - Ybarra, Luiz F.

AU - Benincasa, Susanna

AU - Bellini, Barbara

AU - Candilio, Luciano

AU - Demir, Ozan M.

AU - Hidalgo, Francisco

AU - Karacsonyi, Judit

AU - Gravina, Giacomo

AU - Miccichè, Eligio

AU - D'Agosta, Guido

AU - Venuti, Giuseppe

AU - Tamburino, Corrado

AU - Pan, Manuel

AU - Carlino, Mauro

AU - Dens, Joseph

AU - Brilakis, Emmanouil S.

AU - Colombo, Antonio

AU - Rinfret, Stéphane

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in Fr. ance, the Nethe. rlands, Bel. gium, and Unit. ed Kingdom (RECHARGE) score in predicting acute and long-term outcomes. Methods: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017. The primary end point was target-vessel failure (TVF), a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization on follow-up. Results: Overall, 2058 patients were included (patients who underwent CABG, n = 401; CABG-naïve patients, n = 1657). Patients who had undergone CABG were older and had a higher prevalence of comorbidities and higher occlusion complexity (RECHARGE score, 3.6 ± 1.3 vs 1.8 ± 1.2; P < 0.001). Antegrade dissection/re-entry techniques and the retrograde approach were used more frequently in patients who had undergone CABG. Procedural metrics were worse, and technical (82% vs 88%; P = 0.001) and procedural (81% vs 87%; P = 0.001) success was lower in patients who had undergone CABG. They also experienced a higher rate of major complications (3.7% vs 1.5%; P = 0.004). The RECHARGE score was inversely associated with technical success (P < 0.001). Median follow-up was 377 days (interquartile range, 277-766 days). The 24-month TVF rate was higher in patients who had undergone CABG than in CABG-naïve patients (16.1% vs 9.0%; P < 0.001). On multivariable analysis, the RECHARGE score (hazard ratio, 1.61; P < 0.001) remained an independent predictor of TVF, together with longer total stent length and not using a drug-eluting stent. Conclusions: Compared with CABG-naïve patients, CTO PCI in patients who had undergone CABG shows higher procedural complexity, worse success rates, and higher adjusted risk of TVF on follow-up.

AB - Background: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in Fr. ance, the Nethe. rlands, Bel. gium, and Unit. ed Kingdom (RECHARGE) score in predicting acute and long-term outcomes. Methods: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017. The primary end point was target-vessel failure (TVF), a composite of cardiac death, target-vessel myocardial infarction, and target-vessel revascularization on follow-up. Results: Overall, 2058 patients were included (patients who underwent CABG, n = 401; CABG-naïve patients, n = 1657). Patients who had undergone CABG were older and had a higher prevalence of comorbidities and higher occlusion complexity (RECHARGE score, 3.6 ± 1.3 vs 1.8 ± 1.2; P < 0.001). Antegrade dissection/re-entry techniques and the retrograde approach were used more frequently in patients who had undergone CABG. Procedural metrics were worse, and technical (82% vs 88%; P = 0.001) and procedural (81% vs 87%; P = 0.001) success was lower in patients who had undergone CABG. They also experienced a higher rate of major complications (3.7% vs 1.5%; P = 0.004). The RECHARGE score was inversely associated with technical success (P < 0.001). Median follow-up was 377 days (interquartile range, 277-766 days). The 24-month TVF rate was higher in patients who had undergone CABG than in CABG-naïve patients (16.1% vs 9.0%; P < 0.001). On multivariable analysis, the RECHARGE score (hazard ratio, 1.61; P < 0.001) remained an independent predictor of TVF, together with longer total stent length and not using a drug-eluting stent. Conclusions: Compared with CABG-naïve patients, CTO PCI in patients who had undergone CABG shows higher procedural complexity, worse success rates, and higher adjusted risk of TVF on follow-up.

UR - http://www.scopus.com/inward/record.url?scp=85041000468&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041000468&partnerID=8YFLogxK

U2 - 10.1016/j.cjca.2017.12.016

DO - 10.1016/j.cjca.2017.12.016

M3 - Article

C2 - 29395703

AN - SCOPUS:85041000468

JO - Canadian Journal of Cardiology

JF - Canadian Journal of Cardiology

SN - 0828-282X

ER -