TY - JOUR
T1 - Outcomes of successful vs. failed contemporary chronic total occlusion percutaneous coronary intervention
AU - Megaly, Michael
AU - Khalil, Mahmoud
AU - Basir, Mir B.
AU - McEntegart, Margaret B.
AU - Spratt, James C.
AU - Yamane, Masahisa
AU - Tsuchikane, Etsuo
AU - Xu, Bo
AU - Alaswad, Khaldoon
AU - Brilakis, Emmanouil S.
N1 - Funding Information:
Khaldoon Alaswad: consulting/speaker honoraria from Boston Scientific, Cardiovascular Systems Inc, Abbott Vascular, Teleflex. Mir Basir: Consulting/Speaker Abbott Vascular, Abiomed, Cardiovascular Systems, Chiesi, Zoll. Etsuo Tsuchikane: Consultant for Asahi Intecc, Nipro, KANEKA, and Boston Scientific. Emmanouil Brilakis: consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Amgen, Asahi Intecc, Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), ControlRad, CSI, Elsevier, GE Healthcare, InfraRedx, Medicure, Medtronic, Opsens, Siemens, and Teleflex; research support from Regeneron; owner, Hippocrates LLC; shareholder: MHI Ventures, Cleerly Health. Margaret McEntegart: Consulting/speaker honoraria Abbott Vascular, Biosensors, Boston Scientific, Medtronic, Shockwave Medical, Teleflex. All other authors have nothing to disclose.
Publisher Copyright:
© 2021, Japanese Association of Cardiovascular Intervention and Therapeutics.
PY - 2022/7
Y1 - 2022/7
N2 - Background: There are limited contemporary data on the impact of success vs. failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: We conducted a systematic review and a meta-analysis of contemporary studies that compared the outcomes in patients who underwent successful vs. failed contemporary (2010 onwards) CTO PCI. We performed a sensitivity analysis limited to studies that started enrollment after the publication of the hybrid algorithm in 2012. Results: We included five studies with a total of 6,084 patients (successful CTO PCI n = 4,861, failed CTO PCI n = 1,223). During a median follow-up time of 12 months (range 6–60 months), successful CTO PCI was associated with a lower risk of major adverse cardiovascular events [OR: 0.61, 95% CI (0.41, 0.92), p = 0.02, I2 = 63%] and all-cause death [OR: 0.57, 95% CI (0.33, 0.99), p = 0.05, I2 = 60%]. Both groups had similar risk of myocardial infarction (MI) [OR 0.69, 95% CI (0.43, 1.10), p = 0.38, I2 = 80%], target vessel revascularization (TVR) [OR: 0.56, 95% CI (0.25, 1.27), p = 0.17, I2 = 80%], and stroke [OR: 0.52, 95% CI (0.14, 1.91), p = 0.33, I2 = 0%]. Conclusion: In contemporary practice, successful CTO PCI was associated with a lower incidence of MACE driven by lower all-cause mortality compared with failed CTO PCI at a median follow-up of 1 year.
AB - Background: There are limited contemporary data on the impact of success vs. failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: We conducted a systematic review and a meta-analysis of contemporary studies that compared the outcomes in patients who underwent successful vs. failed contemporary (2010 onwards) CTO PCI. We performed a sensitivity analysis limited to studies that started enrollment after the publication of the hybrid algorithm in 2012. Results: We included five studies with a total of 6,084 patients (successful CTO PCI n = 4,861, failed CTO PCI n = 1,223). During a median follow-up time of 12 months (range 6–60 months), successful CTO PCI was associated with a lower risk of major adverse cardiovascular events [OR: 0.61, 95% CI (0.41, 0.92), p = 0.02, I2 = 63%] and all-cause death [OR: 0.57, 95% CI (0.33, 0.99), p = 0.05, I2 = 60%]. Both groups had similar risk of myocardial infarction (MI) [OR 0.69, 95% CI (0.43, 1.10), p = 0.38, I2 = 80%], target vessel revascularization (TVR) [OR: 0.56, 95% CI (0.25, 1.27), p = 0.17, I2 = 80%], and stroke [OR: 0.52, 95% CI (0.14, 1.91), p = 0.33, I2 = 0%]. Conclusion: In contemporary practice, successful CTO PCI was associated with a lower incidence of MACE driven by lower all-cause mortality compared with failed CTO PCI at a median follow-up of 1 year.
KW - CTO
KW - Chronic total occlusion
KW - PCI
KW - Percutaneous coronary intervention
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U2 - 10.1007/s12928-021-00819-x
DO - 10.1007/s12928-021-00819-x
M3 - Article
C2 - 34716883
AN - SCOPUS:85118305975
SN - 1868-4300
VL - 37
SP - 483
EP - 489
JO - Cardiovascular Intervention and Therapeutics
JF - Cardiovascular Intervention and Therapeutics
IS - 3
ER -