B-19 | Follow-Up Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights from the PROGRESS-CTO Registry
Year: 2023
Type: article
Study design: Observational Study
Abstract: There is limited information on follow-up major adverse cardiac events (MACE) after chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics, as well as procedural and follow-up outcomes of patients who underwent CTO PCI at 38 US and non-US centers between 2012 and 2022 and had follow-up. Of the 3,488 patients with follow-up, 246 (7.1%) experienced MACE, including 73 deaths, 102 acute myocardial infarctions, and 122 target vessel revascularizations (with PCI or coronary artery bypass graft surgery [CABG]). The mean and median follow-up periods were 268±335 and 98 days, respectively. The incidence of MACE at 1, 2, and 3 years was 12%, 23%, and 27%, respectively. Patients with follow-up MACE were more likely to have comorbidities and had more complex lesions as indicated by higher Japanese CTO (J-CTO) scores (2.52 vs 2.33; p=0.026), and longer procedure (135 vs 110 min; p<0.001) and fluoroscopy (48.9 vs 40.0 min; p=0.006) times, higher contrast volume (250 vs 200 mL; p<0.001) and air kerma radiation dose (2.86 vs 2.20; p<0.001). The antegrade crossing strategy was less commonly the successful crossing strategy in patients with follow-up MACE (40.4%) compared with patients without follow-up MACE (58.3%; p<0.001). Cox regression analysis identified parameters associated with follow-up death, acute coronary syndrome, repeat target vessel PCI and target vessel coronary artery bypass graft surgery. Several parameters are associated with follow-up MACE after CTO PCI.
Authors: Athanasios Rempakos, Spyridon Kostantinis, Bahadir Simsek, Judit Karacsonyi, James W. Choi, Paul Poommipanit, Jaikirshan Khatri, Wissam A. Jaber, Stéphane Rinfret, William J. Nicholson, Şevket Görgülü, Farouc A. Jaffer, Brian Jefferson, Khaldoon Alaswad, Oleg Krestyaninov, Dmitrii Khelimskii, Dimitrios Karmpaliotis, Rhian E. Davies, Stewart M. Benton, Nazif Aygul, Jarrod Frizzell, M. Niranjan Reddy, Bavana V. Rangan, Olga Mastrodemos, Salman S. Allana, Yader B. Sandoval, M. Nicholas Burke, Emmanouil S. Brilakis
Institutions: Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, University Hospitals Cleveland Medical Center, Cleveland Clinic, Emory University Hospital, Saint Joseph's Hospital, Emory Healthcare, Massachusetts General Hospital, Centennial Medical Center, Henry Ford Hospital, Meshalkin National Medical Research Center, Morristown Medical Center, Atlantic Health System, WellSpan Health, WellSpan York Hospital, Selçuk University, Christ Hospital, Christ Hospital, Kettering Medical Center
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,400
OpenAlex ID: W4381827845