OBJECTIVES: The purpose of this study was to evaluate long-term clinical outcomes after drug-eluting stent-supported percutaneous coronary intervention (PCI) for native coronary total occlusion (CTO). BACKGROUND: The benefit of successful recanalization of CTO on prognosis remains uncertain. METHODS: Between March 2003 and May 2014, 1,173 consecutive patients with CTO of native coronary vessels requiring PCI were enrolled. Drug-eluting stent implantation was performed in all successful procedures (1,004 patients, 85.6%). RESULTS: During a median follow-up of 4.6 years, the adjusted risks of all-cause mortality (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 0.53 to 2.04; p = 0.92) and the composite of death or myocardial infarction (HR: 1.05; 95% CI: 0.56 to 1.94; p = 0.89) were found to be comparable between patients with successful and failed CTO-PCI, whereas the adjusted risk of target vessel revascularization (HR: 0.15; 95% CI: 0.10 to 0.25; p < 0.001) and coronary artery bypass grafting (HR: 0.02; 95% CI: 0.006 to 0.06, p < 0.001) was significantly higher in patients with failed CTO-PCI. Among patients (n = 879) in whom complete revascularization for non-CTO vessels was performed, the risk of death or the composite of death or myocardial infarction were not found to differ between patients who underwent successful recanalization of the remaining CTO and patients who did not. This finding was consistent regardless of whether the patient had a multivessel disease including CTO or only had a single CTO disease. CONCLUSIONS: Successful CTO-PCI compared with failed PCI was not associated with a lesser risk for mortality. However, successful CTO-PCI was associated with significantly less subsequent coronary artery bypass grafting.
OBJECTIVES: The purpose of this study was to evaluate long-term clinical outcomes after drug-eluting stent-supported percutaneous coronary intervention (PCI) for native coronary total occlusion (CTO). BACKGROUND: The benefit of successful recanalization of CTO on prognosis remains uncertain. METHODS: Between March 2003 and May 2014, 1,173 consecutive patients with CTO of native coronary vessels requiring PCI were enrolled. Drug-eluting stent implantation was performed in all successful procedures (1,004 patients, 85.6%). RESULTS: During a median follow-up of 4.6 years, the adjusted risks of all-cause mortality (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 0.53 to 2.04; p = 0.92) and the composite of death or myocardial infarction (HR: 1.05; 95% CI: 0.56 to 1.94; p = 0.89) were found to be comparable between patients with successful and failed CTO-PCI, whereas the adjusted risk of target vessel revascularization (HR: 0.15; 95% CI: 0.10 to 0.25; p < 0.001) and coronary artery bypass grafting (HR: 0.02; 95% CI: 0.006 to 0.06, p < 0.001) was significantly higher in patients with failed CTO-PCI. Among patients (n = 879) in whom complete revascularization for non-CTO vessels was performed, the risk of death or the composite of death or myocardial infarction were not found to differ between patients who underwent successful recanalization of the remaining CTO and patients who did not. This finding was consistent regardless of whether the patient had a multivessel disease including CTO or only had a single CTO disease. CONCLUSIONS: Successful CTO-PCI compared with failed PCI was not associated with a lesser risk for mortality. However, successful CTO-PCI was associated with significantly less subsequent coronary artery bypass grafting.
Authors: Aurel Toma; Barbara E Stähli; Michael Gick; Cathérine Gebhard; Thomas Nührenberg; Kambis Mashayekhi; Miroslaw Ferenc; Franz-Josef Neumann; Heinz Joachim Buettner Journal: Clin Res Cardiol Date: 2017-02-24 Impact factor: 5.460
Authors: Kathleen Kearney; Ravi S Hira; Robert F Riley; Arun Kalyanasundaram; William L Lombardi Journal: Curr Atheroscler Rep Date: 2017-04 Impact factor: 5.113
Authors: Kai-Ze Wu; Ze-Han Huang; Zhi-An Zhong; Hong-Tao Liao; Yi Zhou; Bing-Zheng Luo; Mahesh Anantha-Narayanan; Rami N Khouzam; Aakash Garg; Vladan Vukcevic; Nicholas G Kounis; Bin Zhang Journal: Ann Transl Med Date: 2019-05
Authors: Se Yeon Choi; Byoung Geol Choi; Seung-Woon Rha; Man Jong Baek; Yang Gi Ryu; Yoonjee Park; Jae Kyeong Byun; Minsuk Shim; Hu Li; Ahmed Mashaly; Won Young Jang; Woohyeun Kim; Jah Yeon Choi; Eun Jin Park; Jin Oh Na; Cheol Ung Choi; Hong Euy Lim; Eung Ju Kim; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh Journal: J Am Heart Assoc Date: 2017-09-13 Impact factor: 5.501