Lorenzo Azzalini1, Soledad Ojeda2, Aris Karatasakis3, Joren Maeremans4, Masaki Tanabe5, Alessio La Manna6, Rustem Dautov7, Luiz F Ybarra8, Susanna Benincasa1, Barbara Bellini1, Luciano Candilio1, Ozan M Demir1, Francisco Hidalgo2, Judit Karacsonyi3, Giacomo Gravina6, Eligio Miccichè6, Guido D'Agosta6, Giuseppe Venuti6, Corrado Tamburino6, Manuel Pan2, Mauro Carlino1, Joseph Dens9, Emmanouil S Brilakis10, Antonio Colombo1, Stéphane Rinfret11. 1. Interventional Cardiology Unit, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy. 2. Division of Interventional Cardiology, Reina Sofia Hospital, University of Córdoba, Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), Córdoba, Spain. 3. Interventional Cardiology Unit, North Texas Healthcare System and University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA. 4. Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Faculty of Medicine and Life Sciences, Universiteit Hasselt, Hasselt, Belgium. 5. Department of Cardiology, Kyoto Okamoto Memorial Hospital, Kyoto, Japan. 6. Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy. 7. Interventional Cardiology, McGill University Health Centre, Montreal, Quebec, Canada; Division of Interventional Cardiology, Quebec Heart and Lung Institute and Laval University, Quebec City, Quebec, Canada. 8. Interventional Cardiology, McGill University Health Centre, Montreal, Quebec, Canada. 9. Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium. 10. Interventional Cardiology Unit, North Texas Healthcare System and University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA; Minneapolis Heart Institute, Minneapolis, MN, USA. 11. Interventional Cardiology, McGill University Health Centre, Montreal, Quebec, Canada; Division of Interventional Cardiology, Quebec Heart and Lung Institute and Laval University, Quebec City, Quebec, Canada. Electronic address: stephane.rinfret@mcgill.ca.
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 France, the Netherlands, Belgium, and United 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.
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 France, the Netherlands, Belgium, and United 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.
Authors: Dagmar F Hernandez-Suarez; Lorenzo Azzalini; Francesco Moroni; João Eduardo Tinoco de Paula; Pablo Lamelas; Carlos M Campos; Marcelo Harada Ribeiro; Evandro Martins Filho; Felix Damas de Los Santos; Lucio Padilla; Marco Alcantara-Melendez; Marcelo A Abud; Israel A Almodóvar-Rivera; Marcia Moura Schmidt; Mauro Echavarria; Antonio Carlos Botelho; Valentin Del Rio; Alexandre Quadros; Ricardo Santiago Journal: Catheter Cardiovasc Interv Date: 2021-12-20 Impact factor: 2.692
Authors: Ali O Malik; John A Spertus; James A Grantham; Poghni Peri-Okonny; Kensey Gosch; James Sapontis; Jeffrey Moses; William Lombardi; Dimitri Karmpaliotis; William J Nicholson; Firas Al Badarin; Adam C Salisbury Journal: Am J Cardiol Date: 2020-01-08 Impact factor: 2.778
Authors: Pablo Salinas; Nieves Gonzalo; Víctor H Moreno; Manuel Fuentes; Sandra Santos-Martinez; José Antonio Fernandez-Diaz; Ignacio J Amat-Santos; Francisco Bosa Ojeda; Juan Caballero Borrego; Javier Cuesta; José María de la Torre Hernández; Alejandro Diego-Nieto; Daniela Dubois; Guillermo Galeote; Javier Goicolea; Alejandro Gutiérrez; Miriam Jiménez-Fernández; Jesús Jiménez-Mazuecos; Alfonso Jurado; Javier Lacunza; Dae-Hyun Lee; María López; Fernando Lozano; Javier Martin-Moreiras; Victoria Martin-Yuste; Raúl Millán; Gema Miñana; Mohsen Mohandes; Francisco J Morales-Ponce; Julio Núñez; Soledad Ojeda; Manuel Pan; Fernando Rivero; Javier Robles; Sergio Rodríguez-Leiras; Sergio Rojas; Juan Rondán; Eva Rumiz; Manel Sabaté; Juan Sanchís; Beatriz Vaquerizo; Javier Escaned Journal: PLoS One Date: 2021-04-02 Impact factor: 3.240