OBJECTIVES: This study sought to assess the impact of chronic total occlusion (CTO) on long-term prognosis in patients with ischemic cardiomyopathy. BACKGROUND: The presence of concomitant CTO in a nonculprit lesion in acute coronary syndromes is associated with worse prognosis. Coronary artery disease is the main cause of heart failure and in many cases at least 1 CTO is observed. METHODS: The study included all patients with systolic heart failure who underwent elective coronary angiography and were registered from January 2009 to December 2014 in the ongoing single-center COMMIT-HF (COnteMporary Modalities In Treatment of Heart Failure) registry (NCT02536443). The patients were divided into 2 groups with regard to CTO presence. All of the analyzed patients were followed up for at least 12 months with all-cause mortality defined as the primary endpoint. RESULTS: Of the 675 patients fulfilling the inclusion and exclusion criteria, 278 patients (41.2%) had 1 or more CTOs of a major coronary artery (+CTO), and in 397 patients (58.8%) the presence of the CTO was not observed (-CTO). The 12-month mortality for the +CTO and -CTO patients was 19.4 % and 10.3 %, respectively (p < 0.001), evident also after 24 months (26.6% vs. 17.6%; p = 0.01). After a multivariate adjustment for differences in baseline characteristics, the presence of CTO remained significantly associated with higher 12-month mortality (relative risk: 1.84: 95% confidence interval: 1.18 to 2.85; p = 0.006). CONCLUSIONS: Our analysis showed that in patients with ischemic heart failure the presence of the CTO is related to worse long-term prognosis.
OBJECTIVES: This study sought to assess the impact of chronic total occlusion (CTO) on long-term prognosis in patients with ischemic cardiomyopathy. BACKGROUND: The presence of concomitant CTO in a nonculprit lesion in acute coronary syndromes is associated with worse prognosis. Coronary artery disease is the main cause of heart failure and in many cases at least 1 CTO is observed. METHODS: The study included all patients with systolic heart failure who underwent elective coronary angiography and were registered from January 2009 to December 2014 in the ongoing single-center COMMIT-HF (COnteMporary Modalities In Treatment of Heart Failure) registry (NCT02536443). The patients were divided into 2 groups with regard to CTO presence. All of the analyzed patients were followed up for at least 12 months with all-cause mortality defined as the primary endpoint. RESULTS: Of the 675 patients fulfilling the inclusion and exclusion criteria, 278 patients (41.2%) had 1 or more CTOs of a major coronary artery (+CTO), and in 397 patients (58.8%) the presence of the CTO was not observed (-CTO). The 12-month mortality for the +CTO and -CTOpatients was 19.4 % and 10.3 %, respectively (p < 0.001), evident also after 24 months (26.6% vs. 17.6%; p = 0.01). After a multivariate adjustment for differences in baseline characteristics, the presence of CTO remained significantly associated with higher 12-month mortality (relative risk: 1.84: 95% confidence interval: 1.18 to 2.85; p = 0.006). CONCLUSIONS: Our analysis showed that in patients with ischemic heart failure the presence of the CTO is related to worse long-term prognosis.
Authors: Yevgeniy Khariton; Sophia Airhart; Adam C Salisbury; John A Spertus; Kensey L Gosch; J Aaron Grantham; Dimitrios Karmpaliotis; Jeffrey W Moses; William J Nicholson; David J Cohen; William Lombardi; James Sapontis; James M McCabe Journal: JACC Cardiovasc Interv Date: 2018-11-26 Impact factor: 11.195
Authors: Waleed Salem El Awady; Mohamed Samy; Mohammad Mustafa Al-Daydamony; Magdy Mohammad Abd El Samei; Khaled Abd El Azim Shokry Journal: Egypt Heart J Date: 2020-05-24
Authors: Ivo M van Dongen; Dilek Yilmaz; Joëlle Elias; Bimmer E P M Claessen; Ronak Delewi; Reinoud E Knops; Arthur A M Wilde; Lieselot van Erven; Martin J Schalij; José P S Henriques Journal: J Am Heart Assoc Date: 2018-05-02 Impact factor: 5.501