Echocardiographic assessment of left ventricular function recovery post percutaneous coronary intervention of chronic total occlusions in patients with low and mid‐range left ventricular ejection fractions

Samy, Mohamed; Awady, Waleed Salem El; Al-Daydamony, Mohammad M.; Samei, Magdy Mohammad Abd El; Shokry, Khaled

doi:10.1111/echo.14582

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…Samy M et al found that left ventricular ejection fraction improvement after successful PCI was signi cantly more in patient with lower ejection fraction group. [25] Galassi AR et al also reported that successful revascularization in patients with left ventricular ejection fraction < 35% improved left ventricular ejection fraction and 2 years all-cause mortality. [26] Moreover, successful PCI was associated with better cardiac survival in elderly especially when complete revascularization is achieved.…”

Section: Discussionmentioning

confidence: 95%

Long term clinical impact of successful recanalization of chronic total occlusion in patients with and without type 2 diabetes mellitus

Tsai

Huang

Teng

et al. 2020

Preprint

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Background: Diabetes mellitus is one of the risk factors for coronary artery disease and frequently associated with multivessels disease and poor clinical outcomes. Long term outcome of successful revascularization of chronic total occlusions (CTO) in diabetes patients remains controversial.Methods and results: From January 2005 to December 2015, 739 patients who underwent revascularization for CTO in Taipei Veterans General Hospital were included in this study, of which 313 (42 %) patients were diabetes patients. Overall successful rate of revascularization was 619 (84%) patients whereas that in diabetics and non-diabetics were 265 (84%) and 354 (83%) respectively. Median follow up was 1095 days (median: 5 years, interquartile range: 1 – 10 years). During 3 years follow-up period, 59 (10%) in successful group and 18 (15%) patients in failure group died. Although successful revascularization of CTO was non-significantly associated with better outcome in total cohort (Hazard ratio (HR):0.593, 95% confidence interval (CI): 0.349–0.008, P:0.054), it might be associated with lower risk of all-cause mortality (HR: 0.307, 95% CI: 0.156 – 0.604, P: 0.001) and CV mortality (HR: 0.266, 95% CI: 0.095 – 0.748, P: 0.012) in diabetics (P: 0.512). In contrast, successful CTO revascularization didn’t improve outcomes in non-diabetics (all p>0.05). In multivariate cox regression analysis, successful CTO revascularization remained an independent predictor for 3-years survival in diabetic subgroup (HR: 0.289, 95% CI: 0.125–0.667, P: 0.004). The multivariate analysis result was similar after propensity score matching (all-cause mortality, HR: 0.348, 95% CI: 0.142 – 0.851, P: 0.021).Conclusions: Successful CTO revascularization in diabetes may be related to better long term survival benefit but not in non-diabetic population.

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Section: Discussionmentioning

confidence: 95%

Long term clinical impact of successful recanalization of chronic total occlusion in patients with and without type 2 diabetes mellitus

Tsai

Huang

Teng

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In our study, diabetes patients were older (mean age was 70 years old) and there was high prevalence of chronic kidney disease and heart failure with reduced ejection fraction. Samy et al found that left ventricular ejection fraction improvement after successful PCI was significantly more in patient with lower ejection fraction group [25]. Galassi et al also reported that successful revascularization in patients with left ventricular ejection fraction ≤ 35% improved left ventricular ejection fraction and 2 years all-cause mortality [26].…”

Section: Discussionmentioning

confidence: 99%

Long term clinical impact of successful recanalization of chronic total occlusion in patients with and without type 2 diabetes mellitus

Tsai

Huang

Teng

et al. 2020

Cardiovasc Diabetol

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Background: Diabetes mellitus is one of the risk factors for coronary artery disease and frequently associated with multivessels disease and poor clinical outcomes. Long term outcome of successful revascularization of chronic total occlusions (CTO) in diabetes patients remains controversial. Methods and results: From January 2005 to December 2015, 739 patients who underwent revascularization for CTO in Taipei Veterans General Hospital were included in this study, of which 313 (42%) patients were diabetes patients. Overall successful rate of revascularization was 619 (84%) patients whereas that in diabetics and non-diabetics were 265 (84%) and 354 (83%) respectively. Median follow up was 1095 days (median: 5 years, interquartile range: 1-10 years). During 3 years follow-up period, 59 (10%) in successful group and 18 (15%) patients in failure group died. Although successful revascularization of CTO was non-significantly associated with better outcome in total cohort (hazard ratio (HR): 0.593, 95% confidence interval (CI) 0.349-0.008, P: 0.054), it might be associated with lower risk of all-cause mortality (HR: 0.307, 95% CI 0.156-0.604, P: 0.001) and CV mortality (HR: 0.266, 95% CI 0.095-0.748, P: 0.012) in diabetics (P: 0.512). In contrast, successful CTO revascularization didn't improve outcomes in non-diabetics (all P > 0.05). In multivariate cox regression analysis, successful CTO revascularization remained an independent predictor for 3-years survival in diabetic subgroup (HR: 0.289, 95% CI 0.125-0.667, P: 0.004). The multivariate analysis result was similar after propensity score matching (all-cause mortality, HR: 0.348, 95% CI 0.142-0.851, P: 0.021). Conclusions: Successful CTO revascularization in diabetes may be related to better long term survival benefit but not in non-diabetic population.

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“…The amount of viable myocardium viability in the CTO-related territory can have an influence on LVEF, and successful revascularization was associated with the recovery of hibernating myocardium and reduction in adverse left ventricular remodeling. Depressed LVEF is well-known to be associated with increased risk of MACEs, and the improvement of LVEF increased electrical stability, reduced ventricular arrhythmias (a main reason for cardiac death), and provided the collateral vessels with protection against future adverse events (34).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Successful Revascularization for Patients With Coronary Chronic Total Occlusions: A Report of 1,655 Patients

Guo

Zhang

et al. 2020

Front. Cardiovasc. Med.

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Background: To date, the benefit of successful revascularization of chronic total occlusions (CTOs) on prognosis remains uncertain, and there is a paucity of data on the impact of successful revascularization for CTO patients on long-term cardiovascular survival. This study aimed to investigate the long-term cardiovascular survival for patients with successful and unsuccessful CTO revascularization in a large cohort of patients. Methods: There were 1,655 consecutive patients with at least one CTO included and were grouped into successful revascularization (n = 591) and unsuccessful revascularization (n = 1,064). Propensity score matching (PSM) was carried out to balance the clinical and the angiographic characteristics. Cardiac mortality was defined as the primary endpoint. Major adverse cardiac event (MACE) was assessed as a "secondary endpoint." Results: After 3.6 years of follow-up, there was no significant difference between the successful and the unsuccessful revascularization groups in the rate of cardiac mortality [adjusted hazard ratio (HR) 0.96, 95% confidence interval (CI) 0.59-1.58, p = 0.865]. After the PSM analysis (371 pairs) between the two groups, the cardiac mortality rate values (HR 0.51, 95% CI 0.23-1.15, p = 0.104) were equivalent, whereas the adjusted risk of MACE (HR 0.43, 95% CI 0.32-0.58, p = 0.001) and target-vessel revascularization (HR 0.41, 95% CI 0.29-0.58, p < 0.001) were significantly higher in patients with unsuccessful revascularization. Conclusion: For the treatment of CTO patients, successful revascularization was not associated with a lesser risk for cardiac mortality as compared with unsuccessful revascularization. However, successful revascularization reduced MACE and target-vessel revascularization.

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Echocardiographic assessment of left ventricular function recovery post percutaneous coronary intervention of chronic total occlusions in patients with low and mid‐range left ventricular ejection fractions

Cited by 8 publications

References 39 publications

Long term clinical impact of successful recanalization of chronic total occlusion in patients with and without type 2 diabetes mellitus

Long term clinical impact of successful recanalization of chronic total occlusion in patients with and without type 2 diabetes mellitus

Long term clinical impact of successful recanalization of chronic total occlusion in patients with and without type 2 diabetes mellitus

Long-Term Outcomes of Successful Revascularization for Patients With Coronary Chronic Total Occlusions: A Report of 1,655 Patients

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