Successful Recanalization of Native Coronary Chronic Total Occlusion Is Not Associated With Improved Long-Term Survival

Lee, Pil Hyung; Lee, Seung-Whan; Park, Hee-Soon; Kang, Se Hun; Bae, Byeong Joo; Chang, Mineok; Roh, Jae‐Hyung; Yoon, Sung‐Han; Ahn, Jung‐Min; Park, Duk‐Woo; Kang, Soo–Jin; Kim, Young‐Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Seung‐Jung

doi:10.1016/j.jcin.2015.11.016

Cited by 82 publications

(46 citation statements)

References 30 publications

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“…Several previous observational studies and meta‐analysis regarding clinical outcomes in patients with successful CTO PCI have demonstrated its beneficial effect, such as improved survival rates and LV function, compared with failed PCI 1, 4, 5, 6, 8, 15. In contrast, some observational studies suggest that successful CTO PCI is not associated with improvement of survival rates and cardiovascular events 16, 17. Thus, these heterogeneous data obscure the necessity of PCI for CTO lesion, and thus it is important to assess whether a patient can gain beneficial effects from a CTO intervention before performing PCI.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Chronic Total Coronary Occlusion With Well‐Developed Collaterals

Choi

Rha

et al. 2017

JAHA

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BackgroundThe impact of percutaneous coronary intervention (PCI) on chronic total occlusion in patients with well‐developed collaterals is not clear.Methods and ResultsA total of 640 chronic total occlusion patients with collateral flow grade ≥2 were divided into 2 groups; chronic total occlusion patients either treated with PCI (the PCI group; n=305) or optimal medical therapy (the optimal medical therapy group; n=335). To adjust for potential confounders, a propensity score matching analysis was performed. Major clinical outcomes were compared between the 2 groups up to 5 years. In the entire population, the PCI group had a lower hazard of myocardial infarction (hazard ratio [HR], 0.177; P=0.039; 95% confidence interval [CI], 0.03–0.91) and the composite of total death or myocardial infarction (HR, 0.298; P=0.017; 95% CI, 0.11–0.80); however, it showed higher hazard of target lesion revascularization (HR, 3.942; P=0.003; 95% CI, 1.58–9.81) and target vessel revascularization (HR, 4.218; P=0.001; 95% CI, 1.85–9.60). After propensity score matching, a total of 158 matched pairs were generated. Although the PCI group showed a higher hazard of target lesion revascularization (HR, 2.868; P=0.027; 95% CI, 1.13–7.31) and target vessel revascularization (HR=2.62; P=0.022; 95% CI, 1.15–5.97), it still exhibited a lower incidence of the composite of total death or myocardial infarction (HR, 0.263; P=0.017; 95% CI, 0.087–0.790). The mean ejection fraction was improved from 47.8% to 51.6% (P<0.001) after PCI.ConclusionsIn our study, successful revascularization by PCI for chronic total occlusion lesions with well‐developed collaterals was associated with lower incidence of death and myocardial infarction, improved left ventricular function, but increased repeat revascularization rate.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Chronic Total Coronary Occlusion With Well‐Developed Collaterals

Choi

Rha

et al. 2017

JAHA

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“…However, Lee et al found no association of successful CTO-PCI on survival in 1173 elective patients with CTO 16. Nonetheless, previous studies were not randomised and lacked a comparison with a conservative control (CTO-No PCI).…”

Section: Discussionmentioning

confidence: 99%

Long-term impact of chronic total occlusion recanalisation in patients with ST-elevation myocardial infarction

Elias

Dongen

Råmunddal

et al. 2018

Heart

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“…Although several multicenter registries have evaluated PCI procedures in Korea,9)10)11)12)13) no nationwide contemporary PCI registries have been collected with standardized collection forms and unified reporting methods. The Korean Society of Cardiology (KSC) and Korean Society of Interventional Cardiology (KSIC) established the Korean percutaneous coronary intervention (K-PCI) registry to collect and report results in a standardized database for PCI case analysis throughout the country.…”

Section: Introductionmentioning

confidence: 99%

The Current Status of Percutaneous Coronary Intervention in Korea: Based on Year 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry

et al. 2017

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Background and ObjectivesAlthough several multicenter registries have evaluated percutaneous coronary intervention (PCI) procedures in Korea, those databases have been limited by non-standardized data collection and lack of uniform reporting methods. We aimed to collect and report data from a standardized database to analyze PCI procedures throughout the country.Materials and Methods Both clinical and procedural data, as well as clinical outcomes data during hospital stay, were collected based on case report forms that used a standard set of 54 data elements. This report is based on 2014 Korean PCI registry cohort data.ResultsA total of 92 hospitals offered data on 44967 PCI procedures. The median age was 66.0 interquartile range 57.0-74.0 years, and 70.3% were men. Thirty-eight percent of patients presented with acute myocardial infarction and one-third of all PCI procedures were performed in an urgent or emergency setting. Non-invasive stress tests were performed in 13.9% of cases, while coronary computed tomography angiography was used in 13.7% of cases prior to PCI. Radial artery access was used in 56.1% of all PCI procedures. Devices that used PCI included drug-eluting stent, plain old balloon angioplasty, drug-eluting balloon, and bare-metal stent (around 91%, 19%, 6%, and 1% of all procedures, respectively). The incidences of in-hospital death, non-fatal myocardial infarction, and stroke were 2.3%, 1.6%, and 0.2%, respectively.ConclusionThese data may provide an overview of the current PCI practices and in-hospital outcomes in Korea and could be used as a foundation for developing treatment guidelines and nationwide clinical research.

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Successful Recanalization of Native Coronary Chronic Total Occlusion Is Not Associated With Improved Long-Term Survival

Abstract: Successful CTO-PCI compared with failed PCI was not associated with a lesser risk for mortality. However, successful CTO-PCI was associated with significantly less subsequent coronary artery bypass grafting.

Cited by 82 publications

References 30 publications

Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Chronic Total Coronary Occlusion With Well‐Developed Collaterals

Percutaneous Coronary Intervention Versus Optimal Medical Therapy for Chronic Total Coronary Occlusion With Well‐Developed Collaterals

Long-term impact of chronic total occlusion recanalisation in patients with ST-elevation myocardial infarction

The Current Status of Percutaneous Coronary Intervention in Korea: Based on Year 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry

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