Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion
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...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-03-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906716300835 |
| _version_ | 1819237500980297728 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Tomohiko Teramoto |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-23T13:21:20Z |
| format | Article |
| id | doaj.art-c660f814b9f14f009d649bda17e33216 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-12-23T13:21:20Z |
| publishDate | 2017-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-c660f814b9f14f009d649bda17e332162022-12-21T17:45:27ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672017-03-0114C283210.1016/j.ijcha.2016.11.001Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusionTomohiko Teramoto0Etsuo Tsuchikane1Masanori Yamamoto2Hitoshi Matsuo3Yoshiaki Kawase4Yoriyasu Suzuki5Seiji Kanou6Tetsurou Shimura7Hirotomo Sato8Maoto Habara9Kenya Nasu10Masashi Kimura11Yoshihisa Kinoshita12Mitsuyasu Terashima13Tetsuo Matsubara14Takahiko Suzuki15Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Gifu Heart Center, Gifu, JapanDepartment of Cardiovascular Medicine, Gifu Heart Center, Gifu, JapanDepartment of Cardiovascular Medicine, Nagoya Heart Center, Nagoya, Aichi, JapanDepartment of Cardiovascular Medicine, Nagoya Heart Center, Nagoya, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanDepartment of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Aichi, JapanBackground: 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.http://www.sciencedirect.com/science/article/pii/S2352906716300835Coronary artery diseasePercutaneous coronary interventionDrug-eluting stentChronic total coronary occlusion |
| spellingShingle | 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 Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion International Journal of Cardiology: Heart & Vasculature Coronary artery disease Percutaneous coronary intervention Drug-eluting stent Chronic total coronary occlusion |
| title | Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion |
| title_full | Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion |
| title_fullStr | Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion |
| title_full_unstemmed | Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion |
| title_short | Successful revascularization improves long-term clinical outcome in patients with chronic coronary total occlusion |
| title_sort | successful revascularization improves long term clinical outcome in patients with chronic coronary total occlusion |
| topic | Coronary artery disease Percutaneous coronary intervention Drug-eluting stent Chronic total coronary occlusion |
| url | http://www.sciencedirect.com/science/article/pii/S2352906716300835 |
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