Abstract
Objective: To assess hard major adverse clinical events (HMACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO). Background: There are limited data regarding long-term HMACE risks based on PCI-CTO success. Methods: First-time PCI was performed in 438 consecutive patients with 473 target CTO lesions. Patients after procedural success (n = 355; 378 CTO lesions) and failure (n = 83; 95 CTO lesions) were followed for an average 40. months (7-77. months range). We compared HMACE (composite of cardiac death, non-fatal myocardial infarction (MI), and stroke) dependent on the success of PCI. Results: The incidence of HMACE was low, with a total of 16 events, and did not differ (6% vs.3.1%, HR = 0.47; CI [0.16-1.35; p = 0.162) dependent on the success of PCI-CTO. There were less cardiac deaths (0.3% vs. 1.2%, RR = 0.22; CI [0.01-3.50];p = 0.283), non fatal MI (1.1% vs.3.6%, RR = 0.27; CI [0.06-1.22], p = 0.089), but more strokes (1.7% vs.1.2%, RR = 1.32; CI [0.16-10.99], p = 0.795) after successful PCI-CTO. Conclusions: The risks of HMACE after PCI-CTO over long-term follow-up were minimal, and do not depend on the procedure success. This unexpected finding somewhat challenge the aggressive interventional approach, and should be confirmed in the adequately powered randomized trial.
Original language | English (US) |
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Journal | Cardiovascular Revascularization Medicine |
DOIs | |
State | Accepted/In press - Oct 22 2015 |
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Keywords
- Chronic total occlusion
- Long-term outcome
- Registry
- Successful recanalization
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Long-term clinical outcomes after successful and failed recanalization to native chronic Total occlusion : Insights from the Busan chronic Total occlusion (B-CTO) Registry. / Kim, Moo Hyun; Mitsudo, Kazuaki; Jin, Cai De; Kim, Tae Hyung; Cho, Young Rak; Park, Jong Sung; Park, Kyungil; Park, Tae Ho; Serebruany, Victor.
In: Cardiovascular Revascularization Medicine, 22.10.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term clinical outcomes after successful and failed recanalization to native chronic Total occlusion
T2 - Insights from the Busan chronic Total occlusion (B-CTO) Registry
AU - Kim, Moo Hyun
AU - Mitsudo, Kazuaki
AU - Jin, Cai De
AU - Kim, Tae Hyung
AU - Cho, Young Rak
AU - Park, Jong Sung
AU - Park, Kyungil
AU - Park, Tae Ho
AU - Serebruany, Victor
PY - 2015/10/22
Y1 - 2015/10/22
N2 - Objective: To assess hard major adverse clinical events (HMACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO). Background: There are limited data regarding long-term HMACE risks based on PCI-CTO success. Methods: First-time PCI was performed in 438 consecutive patients with 473 target CTO lesions. Patients after procedural success (n = 355; 378 CTO lesions) and failure (n = 83; 95 CTO lesions) were followed for an average 40. months (7-77. months range). We compared HMACE (composite of cardiac death, non-fatal myocardial infarction (MI), and stroke) dependent on the success of PCI. Results: The incidence of HMACE was low, with a total of 16 events, and did not differ (6% vs.3.1%, HR = 0.47; CI [0.16-1.35; p = 0.162) dependent on the success of PCI-CTO. There were less cardiac deaths (0.3% vs. 1.2%, RR = 0.22; CI [0.01-3.50];p = 0.283), non fatal MI (1.1% vs.3.6%, RR = 0.27; CI [0.06-1.22], p = 0.089), but more strokes (1.7% vs.1.2%, RR = 1.32; CI [0.16-10.99], p = 0.795) after successful PCI-CTO. Conclusions: The risks of HMACE after PCI-CTO over long-term follow-up were minimal, and do not depend on the procedure success. This unexpected finding somewhat challenge the aggressive interventional approach, and should be confirmed in the adequately powered randomized trial.
AB - Objective: To assess hard major adverse clinical events (HMACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO). Background: There are limited data regarding long-term HMACE risks based on PCI-CTO success. Methods: First-time PCI was performed in 438 consecutive patients with 473 target CTO lesions. Patients after procedural success (n = 355; 378 CTO lesions) and failure (n = 83; 95 CTO lesions) were followed for an average 40. months (7-77. months range). We compared HMACE (composite of cardiac death, non-fatal myocardial infarction (MI), and stroke) dependent on the success of PCI. Results: The incidence of HMACE was low, with a total of 16 events, and did not differ (6% vs.3.1%, HR = 0.47; CI [0.16-1.35; p = 0.162) dependent on the success of PCI-CTO. There were less cardiac deaths (0.3% vs. 1.2%, RR = 0.22; CI [0.01-3.50];p = 0.283), non fatal MI (1.1% vs.3.6%, RR = 0.27; CI [0.06-1.22], p = 0.089), but more strokes (1.7% vs.1.2%, RR = 1.32; CI [0.16-10.99], p = 0.795) after successful PCI-CTO. Conclusions: The risks of HMACE after PCI-CTO over long-term follow-up were minimal, and do not depend on the procedure success. This unexpected finding somewhat challenge the aggressive interventional approach, and should be confirmed in the adequately powered randomized trial.
KW - Chronic total occlusion
KW - Long-term outcome
KW - Registry
KW - Successful recanalization
UR - http://www.scopus.com/inward/record.url?scp=84959552400&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959552400&partnerID=8YFLogxK
U2 - 10.1016/j.carrev.2016.02.011
DO - 10.1016/j.carrev.2016.02.011
M3 - Article
C2 - 26961862
AN - SCOPUS:84959552400
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
SN - 1553-8389
ER -