TY - JOUR
T1 - Coronary chronic total occlusions and mortality in patients with ventricular tachyarrhythmias
AU - Michael, Behnes
AU - Akin, Ibrahim
AU - Kuche, Philipp
AU - Schupp, Tobias
AU - Reiser, Linda
AU - Bollow, Armin
AU - Taton, Gabriel
AU - Reichelt, Thomas
AU - Ellguth, Dominik
AU - Engelke, Niko
AU - Ibrahim-El-Battrawy,
AU - Lang, Siegfried
AU - Brilakis, Emmanouil S.
AU - Azzalini, Lorenzo
AU - Galassi, Alfredo R.
AU - Boukris, Marouane
AU - Neuser, Hans
AU - Neumann, Franz Joseph
AU - Nienaber, Christoph A.
AU - Weiß, Christel
AU - Borggrefe, Martin
AU - Mashayekhi, Kambis
N1 - Publisher Copyright:
© Europa Digital & Publishing 2020. All rights reserved.
PY - 2020/2
Y1 - 2020/2
N2 - Aims: This study sought to assess the prognostic impact of coronary chronic total occlusions (CTO) in patients presenting with ventricular tachyarrhythmias on admission. Methods and results: A large retrospective registry was used, including all consecutive patients presenting with ventricular tachyarrhythmias on admission and undergoing coronary angiography from 2002 to 2016. Patients with a CTO were compared with all other patients (non-CTO) for prognostic outcomes. Statistics comprised Kaplan-Meier and Cox regression analyses. Within a total of 1,461 consecutive patients included with ventricular tachyarrhythmias on admission, a CTO was present in 20%. At midterm follow-up of 18 months, the primary endpoint all-cause mortality had occurred in 40% of CTO patients compared to 27% of non-CTO patients (HR 1.563, 95% CI: 1.263-1.934; p=0.001). The rates of secondary endpoints were higher for in-hospital all-cause mortality at index (29% versus 20%, log-rank p=0.027) and the composite endpoint of cardiac death at 24 hours, recurrent ventricular tachyarrhythmias and appropriate ICD therapies at midterm follow-up (28% versus 20%, log-rank p=0.005). Mortality rates were highest in CTO patients with stable coronary artery disease (CAD), acute myocardial infarction and in patients surviving index hospitalisation. Conclusions: In patients presenting with ventricular tachyarrhythmias on admission, the presence of a coronary CTO is independently associated with an increase of midterm all-cause mortality, in-hospital allcause mortality and the composite endpoint of early cardiac death, recurrent ventricular tachyarrhythmias and appropriate ICD therapies.
AB - Aims: This study sought to assess the prognostic impact of coronary chronic total occlusions (CTO) in patients presenting with ventricular tachyarrhythmias on admission. Methods and results: A large retrospective registry was used, including all consecutive patients presenting with ventricular tachyarrhythmias on admission and undergoing coronary angiography from 2002 to 2016. Patients with a CTO were compared with all other patients (non-CTO) for prognostic outcomes. Statistics comprised Kaplan-Meier and Cox regression analyses. Within a total of 1,461 consecutive patients included with ventricular tachyarrhythmias on admission, a CTO was present in 20%. At midterm follow-up of 18 months, the primary endpoint all-cause mortality had occurred in 40% of CTO patients compared to 27% of non-CTO patients (HR 1.563, 95% CI: 1.263-1.934; p=0.001). The rates of secondary endpoints were higher for in-hospital all-cause mortality at index (29% versus 20%, log-rank p=0.027) and the composite endpoint of cardiac death at 24 hours, recurrent ventricular tachyarrhythmias and appropriate ICD therapies at midterm follow-up (28% versus 20%, log-rank p=0.005). Mortality rates were highest in CTO patients with stable coronary artery disease (CAD), acute myocardial infarction and in patients surviving index hospitalisation. Conclusions: In patients presenting with ventricular tachyarrhythmias on admission, the presence of a coronary CTO is independently associated with an increase of midterm all-cause mortality, in-hospital allcause mortality and the composite endpoint of early cardiac death, recurrent ventricular tachyarrhythmias and appropriate ICD therapies.
KW - Coronary chronic total occlusion
KW - Death
KW - Risk stratification
UR - http://www.scopus.com/inward/record.url?scp=85073223983&partnerID=8YFLogxK
U2 - 10.4244/EIJ-D-18-00496
DO - 10.4244/EIJ-D-18-00496
M3 - Article
AN - SCOPUS:85073223983
SN - 1774-024X
VL - 15
SP - 1278
EP - 1285
JO - EuroIntervention
JF - EuroIntervention
IS - 14
ER -