This large registry study suggests that eptifibatide is noninferior to abciximab in patients with STEMI undergoing primary PCI with respect to death or MI during 1 year, thereby supporting the use of either drug in clinical practice.
Background: The prevalence, treatment and outcomes of balloon undilatable chronic total occlusions (CTOs) have received limited study.
Methods:We examined the prevalence, clinical and angiographic characteristics, and procedural outcomes of percutaneous coronary interventions (PCIs) for balloon undilatable CTOs in a contemporary multicenter US registry.Results: Between 2012 and 2017 data on balloon undilatable lesions were available for 425 consecutive CTO PCIs in 415 patients in whom guidewire crossing was successful: 52 of 425 CTOs were balloon undilatable (12%). Mean patient age was 65 6 10 years and most patients were men (84%). Patients with balloon undilatable CTOs were more likely to be diabetic (67 vs. 41%, P < 0.001) and have heart failure (44 vs. 28%, P 5 0.027). Balloon undilatable CTOs were longer (40 mm [interquartile range, IQR 20-50] vs. 30 [IQR 15-40], P 5 0.016), more likely to have moderate/severe calcification (87 vs. 54%, P < 0.001), and had higher J-CTO score (3.2 6 1.1 vs. 2.5 6 1.3, P < 0.001) and PROGRESS-CTO complications score (3.9 6 1.7 vs. 3.1 6 2.0, P < 0.005). They were associated with lower technical and procedural success (92 vs. 98%, P 5 0.024; and 88 vs. 96%, P 5 0.034, respectively) and higher risk for in-hospital major adverse events (8 vs. 2%, P 5 0.008) due to higher perforation rates. The most frequent treatments for balloon undilatable Catheter Cardiovasc Interv. 2018;91:657-666. wileyonlinelibrary.com/journal/ccd V C 2018 Wiley Periodicals, Inc. | 657
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