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. 2018 Jul 31;59(4):719-726.
doi: 10.1536/ihj.17-360. Epub 2018 Jun 6.

Improved Propensity-Score Matched Long-Term Clinical Outcomes in Patients with Successful Percutaneous Coronary Interventions of Coronary Chronic Total Occlusion

Sinisa Stojkovic  1   2 , Stefan Juricic  1 , Milan Dobric  1   2 , Milan A Nedeljkovic  1   2 , Vladan Vukcevic  1   2 , Dejan Orlic  1   2 , Goran Stankovic  1   2 , Miloje Tomasevic  1   3 , Srdjan Aleksandric  1 , Miodrag Dikic  1 , Milorad Tesic  1 , Zlatko Mehmedbegovic  1 , Nikola Boskovic  2 , Milorad Zivkovic  1 , Vladimir Dedovic  1 , Dejan Milasinovic  1 , Miodrag Ostojic  2 , Branko Beleslin  1   2
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Free article

Improved Propensity-Score Matched Long-Term Clinical Outcomes in Patients with Successful Percutaneous Coronary Interventions of Coronary Chronic Total Occlusion

Sinisa Stojkovic et al. Int Heart J. .
Free article

Abstract

The objective of the study was to evaluate major adverse cardiovascular events (MACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO).Limited data are available on long-term clinical follow-up in the treatment of chronic total occlusion (CTO).Between January 2009 and December 2010 PCI-CTO was attempted in 283 consecutive patients with 289 CTO lesions. Procedural success was 62.3% and clinical follow-up covered 83% (235/283) of the study population with a median follow-up of 66 months (range, 59-74).The total incidence of MACE was 57/235 (24.3%), and was significantly higher in the procedural failure group than in the procedural success group (33/87 (37.9%) versus 24/148 (16.2%), P < 0.001). All-cause mortality was significantly lower in patients with successful PCI-CTO compared to failed PCI-CTO (10.8% versus 20.7%, P < 0.05). Also, the rate of cardiovascular death in the procedural failure group (14.9%) was slightly higher than that in the procedural success group (7.4%, P = 0.066). The rate of TVR was statistically higher in the procedural failure group (P < 0.009). Propensity score-adjusted Cox regression showed that procedural success remained a significant predictor of MACE (adjusted HR 0.402; 95% CI 0.196-0.824; P = 0.013).Our study emphasizes the importance of CTO recanalization in improving long-term outcome including all-cause mortality with a borderline effect on cardiovascular mortality.

Keywords: Coronary artery disease; Long-term survival; Revascularization.

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