Dagmar F Hernandez-Suarez1, Lorenzo Azzalini2, Francesco Moroni2, João Eduardo Tinoco de Paula3, Pablo Lamelas4,5, Carlos M Campos6,7, Marcelo Harada Ribeiro6, Evandro Martins Filho8, Felix Damas de Los Santos9,10, Lucio Padilla4, Marco Alcantara-Melendez11,12, Marcelo A Abud13, Israel A Almodóvar-Rivera14, Marcia Moura Schmidt15, Mauro Echavarria16, Antonio Carlos Botelho17, Valentin Del Rio18,19, Alexandre Quadros15, Ricardo Santiago18,19. 1. Division of Cardiology, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA. 2. Division of Cardiology, VCU Health Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA. 3. Unicor and LMC, Linhares, Brazil. 4. Interventional Cardiology Division, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. 5. Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada. 6. Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. 7. Instituto Prevent Senior, São Paulo, Brazil. 8. Santa Casa de Misericórdia de Maceió, Maceió, Brazil. 9. National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico. 10. Cardiovascular Center Centro Medico ABC, Mexico City, Mexico. 11. Centro Medico Nacional 20 de Noviembre, ISSSTE, Mexico City, Mexico. 12. Hospital Medica Sur, Mexico City, Mexico. 13. Percutaneous Endovascular Therapy Department, Sanatorio San Gerónimo, Santa Fe, Argentina. 14. Department of Mathematical Sciences, University of Puerto Rico, Mayagüez, Puerto Rico. 15. Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre, Brazil. 16. Hospital General ISSSTE, Queretaro, Mexico. 17. Hospital São José do Avai, Itaperuna, Brazil. 18. PCI Cardiology Group, Manatí, Puerto Rico. 19. Bayamon Heart and Lung Institute, Bayamón Medical Center, Bayamón, Puerto Rico.
Abstract
OBJECTIVES: To evaluate the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients with and without prior coronary artery bypass graft (CABG) surgery. BACKGROUND: Data on the outcomes of CTO PCI in patients with versus without CABG remains limited and with scarce representation from developing regions like Latin America. METHODS: We evaluated patients undergoing CTO PCI in 42 centers participating in the LATAM CTO registry between 2008 and 2020. Statistical analyses were stratified according to CABG status. The outcomes of interest were technical and procedural success and in-hospital major adverse cardiac and cerebrovascular events (MACCE). RESULTS: A total of 1662 patients were included (n = 1411 [84.9%] no-CABG and n = 251 [15.1%] prior-CABG). Compared with no-CABG, those with prior-CABG were older (67 ± 11 vs. 64 ± 11 years; p < 0.001), had more comorbidities and lower left ventricular ejection fraction (52.8 ± 12.8% vs. 54.4 ± 11.7%; p = 0.042). Anatomic complexity was higher in the prior-CABG group (J-CTO score 2.46 ± 1.19 vs. 2.10 ± 1.22; p < 0.001; PROGRESS CTO score 1.28 ± 0.89 vs. 0.91 ± 0.85; p < 0.001). Absence of CABG was associated with lower risk of technical and procedural failure (OR: 0.60, 95% CI: 0.43-0.85 and OR: 0.58, 95% CI: 0.40-0.83, respectively). No significant differences in the incidence of in-hospital MACCE (3.8% no-CABG vs. 4.4% prior-CABG; p = 0.766) were observed between groups. CONCLUSION: In a contemporary multicenter CTO-PCI registry from Latin America, prior-CABG patients had more comorbidities, higher anatomical complexity, lower success, and similar in-hospital adverse event rates compared with no-CABG patients.
OBJECTIVES: To evaluate the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients with and without prior coronary artery bypass graft (CABG) surgery. BACKGROUND: Data on the outcomes of CTO PCI in patients with versus without CABG remains limited and with scarce representation from developing regions like Latin America. METHODS: We evaluated patients undergoing CTO PCI in 42 centers participating in the LATAM CTO registry between 2008 and 2020. Statistical analyses were stratified according to CABG status. The outcomes of interest were technical and procedural success and in-hospital major adverse cardiac and cerebrovascular events (MACCE). RESULTS: A total of 1662 patients were included (n = 1411 [84.9%] no-CABG and n = 251 [15.1%] prior-CABG). Compared with no-CABG, those with prior-CABG were older (67 ± 11 vs. 64 ± 11 years; p < 0.001), had more comorbidities and lower left ventricular ejection fraction (52.8 ± 12.8% vs. 54.4 ± 11.7%; p = 0.042). Anatomic complexity was higher in the prior-CABG group (J-CTO score 2.46 ± 1.19 vs. 2.10 ± 1.22; p < 0.001; PROGRESS CTO score 1.28 ± 0.89 vs. 0.91 ± 0.85; p < 0.001). Absence of CABG was associated with lower risk of technical and procedural failure (OR: 0.60, 95% CI: 0.43-0.85 and OR: 0.58, 95% CI: 0.40-0.83, respectively). No significant differences in the incidence of in-hospital MACCE (3.8% no-CABG vs. 4.4% prior-CABG; p = 0.766) were observed between groups. CONCLUSION: In a contemporary multicenter CTO-PCI registry from Latin America, prior-CABG patients had more comorbidities, higher anatomical complexity, lower success, and similar in-hospital adverse event rates compared with no-CABG patients.
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