The Feasibility, Safety and Clinical Benefits for Chronic Total Occlusion (Cto) Pci in Patients With Reduced Ejection Fractions (Ef) Compared to Normal Ef

Barbour, Mohamad Firas; Reddy, Akhil Rasim; Dong, Annie; Grigg, William; Patel, Neil; Brown, Kathleen; Strunk, Adam

doi:10.1016/s0735-1097(21)02619-x

Cited by 1 publication

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“…10 In contrast to our findings, a preliminary study of 65 patients who underwent CTO PCI showed that patients with low LVEF (<50%) had lower recanalization rates (75% vs. 94%) and higher inhospital mortality (3% vs. 0%) compared with patients who had LVEF >50%. 11…”

Section: Complicationsmentioning

confidence: 99%

Outcomes of chronic total occlusion percutaneous coronary intervention in patients with reduced left ventricular ejection fraction

Şimşek

Kostantinis

Karácsonyi

et al. 2022

Cathet Cardio Intervent

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Background The relationship between left ventricular ejection fraction (LVEF) and the success and safety of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods We examined the clinical characteristics and outcomes of CTO PCI in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS‐CTO) after stratifying patients by LVEF (≤35%, 36%–49%, and ≥50%). Results A total of 7827 CTO PCI procedures with LVEF data were included. Mean age was 64 ± 10 years, 81% were men, 43% had diabetes mellitus, 61% had prior PCI, 45% had prior myocardial infarction, and 29% had prior coronary artery bypass graft surgery. Technical success was similar in the three LVEF strata: 85%, 86%, and 87%, p = 0.391 for LVEF ≤35%, 36%–49%, and ≥50%, respectively. In‐hospital mortality was higher in lower LVEF patients (1.1%, 0.4%, and 0.3%, respectively, p = 0.001). In‐hospital major adverse cardiovascular events (MACE) were numerically higher in lower EF patients (2.7%, 2.1%, and 1.9%, p = 0.271). At a median follow‐up of 2 months (interquartile range: 19‐350 days), patients with lower LVEF continued to have higher mortality (4.9%, 3.2%, and 1.4%, p < 0.001) while the MACE rates were similar (9.3%, 9.6%, and 7.4%, p = 0.172). Conclusion CTO PCI can be performed with high technical success in patients with reduced LVEF but is associated with higher in‐hospital and post‐discharge mortality.

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Section: Complicationsmentioning

confidence: 99%