Predictors for adverse outcomes of patients with recanalized chronic total occlusion lesion

Tian, Tao; Guan, Changdong; Gao, Lijian; Yuan, Jianson; Cui, Jingang; Hu, Fenghuan; Tang, Yi-Da; Dou, Kefei; Wu, Yongjian; Yang, Yuejin; Qiao, Shubin; Xu, Bo; Yang, Wei

doi:10.1111/eci.13368

Cited by 4 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Besides, CKD was not routinely evaluated among CTO patients in previous studies. 26 , 33 , 36 In present study, only 51 (7%) patients were with CKD in successful CTO PCI group in our study, and the mean contrast volume was 227mL. Hydration, before and after the CTO procedure, was effective to reduce the occurrence of CIN.…”

Section: Discussionmentioning

confidence: 50%

“… 31 Furthermore, acute kidney injury (AKI) was an independent prognostic factor for long-term mortality among these patients treated with primary PCI. 32 Interestingly, for CTO patients, age and CKD had no predictive value, 33–35 possibly due to the different study populations. Besides, CKD was not routinely evaluated among CTO patients in previous studies.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Adverse Events Among Chronic Total Occlusion Patients Undergoing Successful Percutaneous Coronary Intervention and Medical Therapy

Yang¹,

Guo²,

Lv³

et al. 2021

CIA

View full text Add to dashboard Cite

Objective Limited data are available on the predictors of major adverse cardiac events (MACE) after a successful coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and medical therapy. This study aimed to identify predictors of MACE in CTO patients undergoing successful recanalization and medical therapy. Methods A total of 2015 patients with CTOs were enrolled. About 718 patients underwent successful CTO recanalization, and 1297 patients received medical therapy. The primary outcome was the frequency of MACE, defined as a composite of cardiac death, myocardial infarction, and target-vessel revascularization. Multivariate models were used to determine predictors of MACE. Results In successful CTO recanalization group, MACE occurred in 123 (17.1%) patients. In multivariate analysis, heart failure (hazard ratio [HR] 1.77, 95% confidence interval [CI]: 1.04–3.04, p = 0.036) was identified as independent predictors for MACE in successful CTO recanalization. Additionally, in medical therapy group, the significant predictors of MACE were male gender (HR 1.53, 95% CI: 1.13–2.05, p = 0.005), diabetes mellitus (HR 1.39, 95% CI: 1.11–1.74, p = 0.003), heart failure (HR 1.44, 95% CI: 1.10–1.87, p = 0.007), J-CTO score (HR 1.17, 95% CI: 1.07–1.28, p = 0.001) and multivessel disease (HR 2.20, 95% CI: 1.42–3.39, p < 0.001). Conclusion Heart failure was predictor for composite cardiovascular events in patients with CTO after successful recanalization. Male gender, diabetes mellitus, heart failure, J-CTO score and multivessel disease were predictors of MACE in CTO patients with medical therapy.

show abstract

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Predictors of Adverse Events Among Chronic Total Occlusion Patients Undergoing Successful Percutaneous Coronary Intervention and Medical Therapy

Yang¹,

Guo²,

Lv³

et al. 2021

CIA

View full text Add to dashboard Cite

show abstract

“…Abe et al argued that J-CTO score can predict the prognosis of patients with CTO [ 12 ]. In a five years follow-up study involving over 2000 patients, J-CTO score and residual SYNTAX score were independently associated to TVR (HR, 1.31; 95% CI: 1.11–1.54; P < 0.01) [ 13 ]. However, a small observational study enrolled only 93 patients identified that reduced TIMI flow of target vessel (OR: 11.0, 95% CI: 2.7–45.5, P = 0.001) as well as female (OR: 11.0, 95% CI: 2.1–58.5, p = 0.005) were the predictors of adverse events, indicating the predictive value of target vessel failure [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Long term clinical outcome after success re-attempt percutaneous coronary intervention of chronic total occlusion

Liu

et al. 2023

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background To evaluate the long-term outcome after re-attempt CTO-PCI. Methods This is a retrospective cohort study that included 113 re-attempt CTO-PCI patients who were consecutively registered from January 2019 to December 2020 at Beijing Anzhen Hospital's Center of Coronary Artery Disease. All patients were divided into two groups based on procedural success or failure. The primary endpoint was major adverse cardiac events (MACE), a composite of all-cause mortality, myocardial infarction and target vessel revascularization (TVR). The secondary endpoint was angina after PCI. Results Overall, the successful re-attempt CTO-PCI was archived in 77 patients, the failed CTO-PCI was performed in 36 patients. After a median follow-up of 21.7 months (interquartile range: 10.9–26.0), the incidence of the primary outcome was significantly lower in the success group [14.2% vs. 38.9%, adjusted hazard ratio (HR) 0.351, 95% CI 0.134–0.917, P = 0.033], mainly driven by the reduction of TVR (9.1% vs. 30.6%, adjusted HR 0.238, 95% CI: 0.078–0.72, P = 0.011). Furthermore, patients who had successful re-attempt CTO-PCI had a lower risk of angina after PCI (27.3% vs.61.1%, adjusted HR 0.357, 95% CI 0.167–0.76, P = 0.008). The risk factors of TVR in the patients with successful re-attempt CTO-PCI were stent length > 100 mm (adjusted HR 21.805, 95% CI 1.765–269.368, P = 0.016) and J-CTO score > 3(adjusted HR: 9.733, 95% CI:1.533–61.797, P = 0.016). Conclusions For the patients with previous CTO-PCI failure, a successful re-attempt CTO-PCI was associated with significantly lower MACE, which was primarily driven by a lower TVR rate. More complex CTO lesions and longer stents were the independent predictors of TVR after successful CTO-PCI.

show abstract

“…Moreover, powerful evidence is absent when deciding on the revascularization approach in the special CTO population, including multiple CTOs, left ventricular dysfunction or elderly patients. 11,[17][18][19] Hence, more randomized controlled trials regarding these questions are necessary.…”

mentioning

confidence: 99%

The Comparison of Long-Term Outcome Between Patients with Single and Multiple Coronary Chronic Total Occlusions After Percutaneous Coronary Intervention

Cao¹,

Li²,

Sun³

2022

IJGM

View full text Add to dashboard Cite

Background Rapid advancements in percutaneous coronary intervention (PCI) have improved the outcome of chronic coronary total occlusions (CTOs); however, data regarding the difference in long-term outcomes in stable coronary artery disease (CAD) patients with single and multiple CTOs who underwent PCI are scarce. This study aimed to compare the long-term outcomes of patients with multiple CTOs and single CTO after PCI. Methods This study cohort included stable CAD patients who were diagnosed with CTO and treated with PCI from a single center. The primary endpoint was all-cause death. Results We retrospectively reviewed 670 consecutive patients with CTO-PCI. Among them, 539 patients had a single CTO, and 131 (19.7%) patients had multiple (at least two) CTOs. CTO revascularization was achieved in 470 (70.1%) patients. After a median follow-up duration of 33.7 months, the cumulative all-cause mortality (p = 0.037) and cardiac mortality (p = 0.003) were higher in patients with multiple CTOs than in those with a single CTO. In the multivariable model, multiple CTOs and left ventricular ejection fraction (LVEF) less than 40% were independent predictors for cardiac death (adjusted hazard ratio (HR) 2.53; P = 0.013 and adjusted HR 3.95; P < 0.001), while age older than 65 and LVEF less than 40% were independent predictors for all-cause death in CTO-PCI patients (adjusted hazard ratio (HR) 1.84; P = 0.035 and adjusted HR 2.54; P = 0.001). Conclusion In CTO-PCI patients, long-term survival was associated with multiple CTOs, age and LVEF, but not with CTO revascularization.

show abstract

Predictors for adverse outcomes of patients with recanalized chronic total occlusion lesion

Cited by 4 publications

References 28 publications

Predictors of Adverse Events Among Chronic Total Occlusion Patients Undergoing Successful Percutaneous Coronary Intervention and Medical Therapy

Predictors of Adverse Events Among Chronic Total Occlusion Patients Undergoing Successful Percutaneous Coronary Intervention and Medical Therapy

Long term clinical outcome after success re-attempt percutaneous coronary intervention of chronic total occlusion

The Comparison of Long-Term Outcome Between Patients with Single and Multiple Coronary Chronic Total Occlusions After Percutaneous Coronary Intervention

Contact Info

Product

Resources

About