Tatsuya Nishikawa1,2, Masashi Fujino1,3, Ikutaro Nakajima1, Yasuhide Asaumi1, Yu Kataoka1, Toshihisa Anzai1, Kengo Kusano1, Teruo Noguchi1, Yoichi Goto1, Kunihiro Nishimura4, Yoshihiro Miyamoto4, Keisuke Kiso5, Satoshi Yasuda1,3. 1. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. 2. Department of Pathophysiology Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan. 3. Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. 4. Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 5. Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Abstract
AIMS: The prognostic impact of chronic total coronary occlusion (CTO) on implantable cardioverter-defibrillator (ICD) recipients remains unclear. METHODS AND RESULTS: Eighty-four consecutive patients with ischaemic heart disease who received ICD therapy for primary or secondary prevention were analysed. We investigated all-cause mortality and major adverse cardiac events (MACEs) including cardiac death, appropriate device therapy, hospitalization for heart failure, and ventricular assist device implantation. Of the study patients (mean age 70 ± 8 years; 86% men), 34 (40%) had CTO. There were no significant differences in age, left ventricular ejection fraction (LVEF), New York Heart Association functional class III or IV status, and proportion who underwent secondary prevention between patients with CTO (CTO group) and without CTO (non-CTO group). During a median follow-up of 3.8 years (interquartile range 2.7-5.4 years), the CTO group tended to have a higher MACE rate (log-rank P = 0.054) than the non-CTO group. Within the CTO group, there was no difference in the MACE rate between patients with and without viable myocardium. In patients with ICD for secondary prevention (n = 47), 16 patients (34%) with CTO had a higher MACE rate than patients without CTO (log-rank P < 0.01). Cox proportional hazards regression analysis showed that the presence of CTO, but not LVEF, was associated with a higher MACE rate. Multivariate analysis showed that the presence of CTO was a predictor of MACE (P < 0.05). CONCLUSION: In patients with ischaemic heart disease receiving ICD implantation, the presence of CTO has an adverse impact on long-term prognosis, especially as secondary prevention. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The prognostic impact of chronic total coronary occlusion (CTO) on implantable cardioverter-defibrillator (ICD) recipients remains unclear. METHODS AND RESULTS: Eighty-four consecutive patients with ischaemic heart disease who received ICD therapy for primary or secondary prevention were analysed. We investigated all-cause mortality and major adverse cardiac events (MACEs) including cardiac death, appropriate device therapy, hospitalization for heart failure, and ventricular assist device implantation. Of the study patients (mean age 70 ± 8 years; 86% men), 34 (40%) had CTO. There were no significant differences in age, left ventricular ejection fraction (LVEF), New York Heart Association functional class III or IV status, and proportion who underwent secondary prevention between patients with CTO (CTO group) and without CTO (non-CTO group). During a median follow-up of 3.8 years (interquartile range 2.7-5.4 years), the CTO group tended to have a higher MACE rate (log-rank P = 0.054) than the non-CTO group. Within the CTO group, there was no difference in the MACE rate between patients with and without viable myocardium. In patients with ICD for secondary prevention (n = 47), 16 patients (34%) with CTO had a higher MACE rate than patients without CTO (log-rank P < 0.01). Cox proportional hazards regression analysis showed that the presence of CTO, but not LVEF, was associated with a higher MACE rate. Multivariate analysis showed that the presence of CTO was a predictor of MACE (P < 0.05). CONCLUSION: In patients with ischaemic heart disease receiving ICD implantation, the presence of CTO has an adverse impact on long-term prognosis, especially as secondary prevention. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Michael Behnes; Kambis Mashayekhi; Philipp Kuche; Seung-Hyun Kim; Tobias Schupp; Max von Zworowsky; Linda Reiser; Armin Bollow; Gabriel Taton; Thomas Reichelt; Martin Borggrefe; Dominik Ellguth; Niko Engelke; Kathrin Weidner; Simon Lindner; Julian Müller; Uzair Ansari; Dirk Große Meininghaus; Thomas Bertsch; Siegfried Lang; Ibrahim Akin Journal: Clin Res Cardiol Date: 2020-11-04 Impact factor: 5.460
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