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

Keywords

  • Chronic total occlusion
  • Long-term outcome
  • Registry
  • Successful recanalization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Long-term clinical outcomes after successful and failed recanalization to native chronic Total occlusion: Insights from the Busan chronic Total occlusion (B-CTO) Registry'. Together they form a unique fingerprint.

  • Cite this