Long-term clinical outcomes after successful and failed recanalization to native chronic Total occlusion: Insights from the Busan chronic Total occlusion (B-CTO) Registry

Moo Hyun Kim, Kazuaki Mitsudo, Cai De Jin, Tae Hyung Kim, Young Rak Cho, Jong Sung Park, Kyungil Park, Tae Ho Park, Victor Serebruany

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalCardiovascular Revascularization Medicine
DOIs
StateAccepted/In press - Oct 22 2015

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Percutaneous Coronary Intervention
Registries
Stroke
Myocardial Infarction
Incidence

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 journalArticle

Kim, Moo Hyun ; Mitsudo, Kazuaki ; Jin, Cai De ; Kim, Tae Hyung ; Cho, Young Rak ; Park, Jong Sung ; Park, Kyungil ; Park, Tae Ho ; Serebruany, Victor. / Long-term clinical outcomes after successful and failed recanalization to native chronic Total occlusion : Insights from the Busan chronic Total occlusion (B-CTO) Registry. In: Cardiovascular Revascularization Medicine. 2015.
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title = "Long-term clinical outcomes after successful and failed recanalization to native chronic Total occlusion: Insights from the Busan chronic Total occlusion (B-CTO) Registry",
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.",
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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

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