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) |
|---|---|
| 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 -