Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion

Tomohiko Teramoto, Etsuo Tsuchikane, Masanori Yamamoto, Hitoshi Matsuo, Yoshiaki Kawase, Yoriyasu Suzuki, Seiji Kanou, Tetsurou Shimura, Hirotomo Sato, Maoto Habara, Kenya Nasu, Masashi Kimura, Yoshihisa Kinoshita, Mitsuyasu Terashima, Tetsuo Matsubara, Takahiko Suzuki

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background Following the development of breakthrough techniques for percutaneous coronary intervention (PCI) in the treatment of chronic total occlusions (CTO), the initial success rate of PCI in CTO lesions (CTO-PCI) has improved; however, there are few reports regarding the effects of successful CTO revascularization on long-term mortality in Japan. The aim of this study was to compare the long-term clinical outcomes of patients with successful versus failed CTO recanalization and to identify related factors. Methods and results From all PCI procedures performed in our hospital between 2006 and 2013, CTO-PCIs were extracted and classified into two groups: PCI success (n = 656 patients) and PCI failure (n = 82 patients). Patients with successful procedures only on a second attempt, CTO-PCI in small branches, or CTOs in more than one vessel were excluded. Survival was determined from a telephone interview or the consultation history in the outpatient clinic. Initial angiographic success was achieved in 88.9% of the patients. A Kaplan–Meier plot with log-rank analysis showed that cumulative all-cause death was significantly lower in the success group than in the failure group (p = 0.0003; average follow-up duration in success group vs. failure group was 1531.3 ± 33.5 vs. 1565.3 ± 97.5 days, p = 0.7). Moreover, the rate of evident cardiac death was significantly lower in the success group than in the failure group (3.5% [23/656] vs. 15.9% [13/82], p < 0.0001). Conclusions This study suggests that successful revascularization in patients with CTO improves their long-term clinical outcomes.

Original languageEnglish
Pages (from-to)28-32
Number of pages5
JournalIJC Heart and Vasculature
Volume14
DOIs
StatePublished - 1 Mar 2017
Externally publishedYes

Keywords

  • Chronic total coronary occlusion
  • Coronary artery disease
  • Drug-eluting stent
  • Percutaneous coronary intervention

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