Long-term clinical outcomes of successful versus unsuccessful revascularization with drug-eluting stents for true chronic total occlusion
Objectives: The aims of this study were to investigate the long‐term clinical outcomes of patients with successful versus unsuccessful revascularization with drug‐eluting stents (DES) for chronic total occlusion (CTO). Background: The benefits of successful revascularization of CTO remain unclear. M...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2011-09, Vol.78 (3), p.346-353 |
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| creator | Lee, Seung-Whan Lee, Jong-Young Park, Duk-Woo Kim, Young-Hak Yun, Sung-Cheol Kim, Won-Jang Suh, Jon Cho, Yoon Hang Lee, Nae-Hee Kang, Soo-Jin Lee, Cheol Whan Park, Seong-Wook Park, Seung-Jung |
| description | Objectives: The aims of this study were to investigate the long‐term clinical outcomes of patients with successful versus unsuccessful revascularization with drug‐eluting stents (DES) for chronic total occlusion (CTO). Background: The benefits of successful revascularization of CTO remain unclear. Methods: Consecutive patients (n = 333) with “true” CTO, defined as Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 on angiography and duration ≥3 months, were divided into two groups, those with successful (CTO success group, n = 251) and unsuccessful (CTO failure group, n = 82) revascularization with DES for CTO lesions. The primary endpoint was defined as major adverse cardiac events (MACE) the composite of death, Q‐wave myocardial infarction (MI), or target vessel revascularization (TVR). Results: The CTO success group was significantly younger, with a higher involvement of LAD, and lower incidences of renal failure, previous myocardial infarction, and previous coronary intervention than the CTO failure group. After a median follow up of 1,317 days (interquartile range, 1,059–1,590 days), there were no significant between‐group differences in rate of MACE, both after crude analysis (9.4% vs. 11.8%, log‐rank P = 0.16) and after adjustment (HR 1.17; 95% CI 0.47–2.88, P = 0.53). On multivariate analysis, major predictors of MACE were left ventricle ejection fraction (LVEF) |
| doi_str_mv | 10.1002/ccd.23019 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_896828845</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>896828845</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4329-8f8ca04a1298d7be0dd218918ace8d2919d0ff06134b948cfba7801366eeb12d3</originalsourceid><addsrcrecordid>eNp1kMtu1DAUhi0EoqWw4AWQd4hFWttxEnuJBiiVhou47yzHPp4anLj40lLeoG9NykwrNqyOdfz9_5E-hB5TckgJYUfG2EPWEirvoH3aMdYMrP92d_emkvd76EHO3wkhsmfyPtpjlC9fXOyjq3WcN02BNGET_OyNDjjWYuIEGUeHczUGcnY14HNIuWZc5392Cc51NjXo5H_r4uOML3w5xTbVTQOhFj9vcC4wl4xdTLikCticprgcwiWW62PGhJqX5EN0z-mQ4dFuHqDPr15-Wr1u1u-OT1bP143hLZONcMJowjVlUthhBGIto0JSoQ0IyySVljhHetryUXJh3KgHQWjb9wAjZbY9QE-3vWcp_qyQi5p8NhCCniHWrITsBROCdwv5bEuaFHNO4NRZ8pNOl4oSdS1eLeLVX_EL-2TXWscJ7C15Y3oBjrbAhQ9w-f8mtVq9uKlstgm_GPx1m9Dph-qHdujU17fH6gt9z7sPbz6qrv0DO1OgGw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>896828845</pqid></control><display><type>article</type><title>Long-term clinical outcomes of successful versus unsuccessful revascularization with drug-eluting stents for true chronic total occlusion</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Lee, Seung-Whan ; Lee, Jong-Young ; Park, Duk-Woo ; Kim, Young-Hak ; Yun, Sung-Cheol ; Kim, Won-Jang ; Suh, Jon ; Cho, Yoon Hang ; Lee, Nae-Hee ; Kang, Soo-Jin ; Lee, Cheol Whan ; Park, Seong-Wook ; Park, Seung-Jung</creator><creatorcontrib>Lee, Seung-Whan ; Lee, Jong-Young ; Park, Duk-Woo ; Kim, Young-Hak ; Yun, Sung-Cheol ; Kim, Won-Jang ; Suh, Jon ; Cho, Yoon Hang ; Lee, Nae-Hee ; Kang, Soo-Jin ; Lee, Cheol Whan ; Park, Seong-Wook ; Park, Seung-Jung</creatorcontrib><description>Objectives: The aims of this study were to investigate the long‐term clinical outcomes of patients with successful versus unsuccessful revascularization with drug‐eluting stents (DES) for chronic total occlusion (CTO). Background: The benefits of successful revascularization of CTO remain unclear. Methods: Consecutive patients (n = 333) with “true” CTO, defined as Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 on angiography and duration ≥3 months, were divided into two groups, those with successful (CTO success group, n = 251) and unsuccessful (CTO failure group, n = 82) revascularization with DES for CTO lesions. The primary endpoint was defined as major adverse cardiac events (MACE) the composite of death, Q‐wave myocardial infarction (MI), or target vessel revascularization (TVR). Results: The CTO success group was significantly younger, with a higher involvement of LAD, and lower incidences of renal failure, previous myocardial infarction, and previous coronary intervention than the CTO failure group. After a median follow up of 1,317 days (interquartile range, 1,059–1,590 days), there were no significant between‐group differences in rate of MACE, both after crude analysis (9.4% vs. 11.8%, log‐rank P = 0.16) and after adjustment (HR 1.17; 95% CI 0.47–2.88, P = 0.53). On multivariate analysis, major predictors of MACE were left ventricle ejection fraction (LVEF) <40% (HR 3.14; 95% CI 1.39–7.09, P = 0.005) and multiple CTO (HR 2.38; 95% CI 1.01–5.71, P = 0.049). Conclusions: Long‐term clinical outcomes were similar in the CTO success and failure groups. Multiple CTOs and LVEF <40% in CTO patients were independent predictors of MACE. © 2011 Wiley‐Liss, Inc.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.23019</identifier><identifier>PMID: 21452248</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Aged ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - instrumentation ; Angioplasty, Balloon, Coronary - mortality ; Chi-Square Distribution ; Chronic Disease ; chronic total occlusion ; Coronary Angiography ; Coronary Circulation ; Coronary Occlusion - diagnostic imaging ; Coronary Occlusion - mortality ; Coronary Occlusion - physiopathology ; Coronary Occlusion - therapy ; Drug-Eluting Stents ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Propensity Score ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; revascularization ; Risk Assessment ; Risk Factors ; Stroke Volume ; Thrombosis - etiology ; Thrombosis - mortality ; Thrombosis - therapy ; Time Factors ; Treatment Failure ; Ventricular Function, Left</subject><ispartof>Catheterization and cardiovascular interventions, 2011-09, Vol.78 (3), p.346-353</ispartof><rights>Copyright © 2011 Wiley‐Liss, Inc.</rights><rights>Copyright © 2011 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4329-8f8ca04a1298d7be0dd218918ace8d2919d0ff06134b948cfba7801366eeb12d3</citedby><cites>FETCH-LOGICAL-c4329-8f8ca04a1298d7be0dd218918ace8d2919d0ff06134b948cfba7801366eeb12d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.23019$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.23019$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21452248$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Seung-Whan</creatorcontrib><creatorcontrib>Lee, Jong-Young</creatorcontrib><creatorcontrib>Park, Duk-Woo</creatorcontrib><creatorcontrib>Kim, Young-Hak</creatorcontrib><creatorcontrib>Yun, Sung-Cheol</creatorcontrib><creatorcontrib>Kim, Won-Jang</creatorcontrib><creatorcontrib>Suh, Jon</creatorcontrib><creatorcontrib>Cho, Yoon Hang</creatorcontrib><creatorcontrib>Lee, Nae-Hee</creatorcontrib><creatorcontrib>Kang, Soo-Jin</creatorcontrib><creatorcontrib>Lee, Cheol Whan</creatorcontrib><creatorcontrib>Park, Seong-Wook</creatorcontrib><creatorcontrib>Park, Seung-Jung</creatorcontrib><title>Long-term clinical outcomes of successful versus unsuccessful revascularization with drug-eluting stents for true chronic total occlusion</title><title>Catheterization and cardiovascular interventions</title><addtitle>Cathet. Cardiovasc. Intervent</addtitle><description>Objectives: The aims of this study were to investigate the long‐term clinical outcomes of patients with successful versus unsuccessful revascularization with drug‐eluting stents (DES) for chronic total occlusion (CTO). Background: The benefits of successful revascularization of CTO remain unclear. Methods: Consecutive patients (n = 333) with “true” CTO, defined as Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 on angiography and duration ≥3 months, were divided into two groups, those with successful (CTO success group, n = 251) and unsuccessful (CTO failure group, n = 82) revascularization with DES for CTO lesions. The primary endpoint was defined as major adverse cardiac events (MACE) the composite of death, Q‐wave myocardial infarction (MI), or target vessel revascularization (TVR). Results: The CTO success group was significantly younger, with a higher involvement of LAD, and lower incidences of renal failure, previous myocardial infarction, and previous coronary intervention than the CTO failure group. After a median follow up of 1,317 days (interquartile range, 1,059–1,590 days), there were no significant between‐group differences in rate of MACE, both after crude analysis (9.4% vs. 11.8%, log‐rank P = 0.16) and after adjustment (HR 1.17; 95% CI 0.47–2.88, P = 0.53). On multivariate analysis, major predictors of MACE were left ventricle ejection fraction (LVEF) <40% (HR 3.14; 95% CI 1.39–7.09, P = 0.005) and multiple CTO (HR 2.38; 95% CI 1.01–5.71, P = 0.049). Conclusions: Long‐term clinical outcomes were similar in the CTO success and failure groups. Multiple CTOs and LVEF <40% in CTO patients were independent predictors of MACE. © 2011 Wiley‐Liss, Inc.</description><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Angioplasty, Balloon, Coronary - instrumentation</subject><subject>Angioplasty, Balloon, Coronary - mortality</subject><subject>Chi-Square Distribution</subject><subject>Chronic Disease</subject><subject>chronic total occlusion</subject><subject>Coronary Angiography</subject><subject>Coronary Circulation</subject><subject>Coronary Occlusion - diagnostic imaging</subject><subject>Coronary Occlusion - mortality</subject><subject>Coronary Occlusion - physiopathology</subject><subject>Coronary Occlusion - therapy</subject><subject>Drug-Eluting Stents</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Propensity Score</subject><subject>Proportional Hazards Models</subject><subject>Republic of Korea</subject><subject>Retrospective Studies</subject><subject>revascularization</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Thrombosis - etiology</subject><subject>Thrombosis - mortality</subject><subject>Thrombosis - therapy</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><subject>Ventricular Function, Left</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtu1DAUhi0EoqWw4AWQd4hFWttxEnuJBiiVhou47yzHPp4anLj40lLeoG9NykwrNqyOdfz9_5E-hB5TckgJYUfG2EPWEirvoH3aMdYMrP92d_emkvd76EHO3wkhsmfyPtpjlC9fXOyjq3WcN02BNGET_OyNDjjWYuIEGUeHczUGcnY14HNIuWZc5392Cc51NjXo5H_r4uOML3w5xTbVTQOhFj9vcC4wl4xdTLikCticprgcwiWW62PGhJqX5EN0z-mQ4dFuHqDPr15-Wr1u1u-OT1bP143hLZONcMJowjVlUthhBGIto0JSoQ0IyySVljhHetryUXJh3KgHQWjb9wAjZbY9QE-3vWcp_qyQi5p8NhCCniHWrITsBROCdwv5bEuaFHNO4NRZ8pNOl4oSdS1eLeLVX_EL-2TXWscJ7C15Y3oBjrbAhQ9w-f8mtVq9uKlstgm_GPx1m9Dph-qHdujU17fH6gt9z7sPbz6qrv0DO1OgGw</recordid><startdate>20110901</startdate><enddate>20110901</enddate><creator>Lee, Seung-Whan</creator><creator>Lee, Jong-Young</creator><creator>Park, Duk-Woo</creator><creator>Kim, Young-Hak</creator><creator>Yun, Sung-Cheol</creator><creator>Kim, Won-Jang</creator><creator>Suh, Jon</creator><creator>Cho, Yoon Hang</creator><creator>Lee, Nae-Hee</creator><creator>Kang, Soo-Jin</creator><creator>Lee, Cheol Whan</creator><creator>Park, Seong-Wook</creator><creator>Park, Seung-Jung</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110901</creationdate><title>Long-term clinical outcomes of successful versus unsuccessful revascularization with drug-eluting stents for true chronic total occlusion</title><author>Lee, Seung-Whan ; Lee, Jong-Young ; Park, Duk-Woo ; Kim, Young-Hak ; Yun, Sung-Cheol ; Kim, Won-Jang ; Suh, Jon ; Cho, Yoon Hang ; Lee, Nae-Hee ; Kang, Soo-Jin ; Lee, Cheol Whan ; Park, Seong-Wook ; Park, Seung-Jung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4329-8f8ca04a1298d7be0dd218918ace8d2919d0ff06134b948cfba7801366eeb12d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary - adverse effects</topic><topic>Angioplasty, Balloon, Coronary - instrumentation</topic><topic>Angioplasty, Balloon, Coronary - mortality</topic><topic>Chi-Square Distribution</topic><topic>Chronic Disease</topic><topic>chronic total occlusion</topic><topic>Coronary Angiography</topic><topic>Coronary Circulation</topic><topic>Coronary Occlusion - diagnostic imaging</topic><topic>Coronary Occlusion - mortality</topic><topic>Coronary Occlusion - physiopathology</topic><topic>Coronary Occlusion - therapy</topic><topic>Drug-Eluting Stents</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Propensity Score</topic><topic>Proportional Hazards Models</topic><topic>Republic of Korea</topic><topic>Retrospective Studies</topic><topic>revascularization</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Thrombosis - etiology</topic><topic>Thrombosis - mortality</topic><topic>Thrombosis - therapy</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Seung-Whan</creatorcontrib><creatorcontrib>Lee, Jong-Young</creatorcontrib><creatorcontrib>Park, Duk-Woo</creatorcontrib><creatorcontrib>Kim, Young-Hak</creatorcontrib><creatorcontrib>Yun, Sung-Cheol</creatorcontrib><creatorcontrib>Kim, Won-Jang</creatorcontrib><creatorcontrib>Suh, Jon</creatorcontrib><creatorcontrib>Cho, Yoon Hang</creatorcontrib><creatorcontrib>Lee, Nae-Hee</creatorcontrib><creatorcontrib>Kang, Soo-Jin</creatorcontrib><creatorcontrib>Lee, Cheol Whan</creatorcontrib><creatorcontrib>Park, Seong-Wook</creatorcontrib><creatorcontrib>Park, Seung-Jung</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Seung-Whan</au><au>Lee, Jong-Young</au><au>Park, Duk-Woo</au><au>Kim, Young-Hak</au><au>Yun, Sung-Cheol</au><au>Kim, Won-Jang</au><au>Suh, Jon</au><au>Cho, Yoon Hang</au><au>Lee, Nae-Hee</au><au>Kang, Soo-Jin</au><au>Lee, Cheol Whan</au><au>Park, Seong-Wook</au><au>Park, Seung-Jung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term clinical outcomes of successful versus unsuccessful revascularization with drug-eluting stents for true chronic total occlusion</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Cathet. Cardiovasc. Intervent</addtitle><date>2011-09-01</date><risdate>2011</risdate><volume>78</volume><issue>3</issue><spage>346</spage><epage>353</epage><pages>346-353</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Objectives: The aims of this study were to investigate the long‐term clinical outcomes of patients with successful versus unsuccessful revascularization with drug‐eluting stents (DES) for chronic total occlusion (CTO). Background: The benefits of successful revascularization of CTO remain unclear. Methods: Consecutive patients (n = 333) with “true” CTO, defined as Thrombolysis In Myocardial Infarction (TIMI) flow grade 0 on angiography and duration ≥3 months, were divided into two groups, those with successful (CTO success group, n = 251) and unsuccessful (CTO failure group, n = 82) revascularization with DES for CTO lesions. The primary endpoint was defined as major adverse cardiac events (MACE) the composite of death, Q‐wave myocardial infarction (MI), or target vessel revascularization (TVR). Results: The CTO success group was significantly younger, with a higher involvement of LAD, and lower incidences of renal failure, previous myocardial infarction, and previous coronary intervention than the CTO failure group. After a median follow up of 1,317 days (interquartile range, 1,059–1,590 days), there were no significant between‐group differences in rate of MACE, both after crude analysis (9.4% vs. 11.8%, log‐rank P = 0.16) and after adjustment (HR 1.17; 95% CI 0.47–2.88, P = 0.53). On multivariate analysis, major predictors of MACE were left ventricle ejection fraction (LVEF) <40% (HR 3.14; 95% CI 1.39–7.09, P = 0.005) and multiple CTO (HR 2.38; 95% CI 1.01–5.71, P = 0.049). Conclusions: Long‐term clinical outcomes were similar in the CTO success and failure groups. Multiple CTOs and LVEF <40% in CTO patients were independent predictors of MACE. © 2011 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21452248</pmid><doi>10.1002/ccd.23019</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Angioplasty, Balloon, Coronary - adverse effects Angioplasty, Balloon, Coronary - instrumentation Angioplasty, Balloon, Coronary - mortality Chi-Square Distribution Chronic Disease chronic total occlusion Coronary Angiography Coronary Circulation Coronary Occlusion - diagnostic imaging Coronary Occlusion - mortality Coronary Occlusion - physiopathology Coronary Occlusion - therapy Drug-Eluting Stents Female Humans Kaplan-Meier Estimate Logistic Models Male Middle Aged Myocardial Infarction - etiology Myocardial Infarction - mortality Myocardial Infarction - therapy Propensity Score Proportional Hazards Models Republic of Korea Retrospective Studies revascularization Risk Assessment Risk Factors Stroke Volume Thrombosis - etiology Thrombosis - mortality Thrombosis - therapy Time Factors Treatment Failure Ventricular Function, Left |
| title | Long-term clinical outcomes of successful versus unsuccessful revascularization with drug-eluting stents for true chronic total occlusion |
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