TY - JOUR
T1 - The impact of successful chronic total occlusion percutaneous coronary intervention on clinical outcomes
T2 - a tertiary single-center analysis
AU - Will, Maximilian
AU - Schwarz, Konstantin
AU - Aufhauser, Simone
AU - Leibundgut, Gregor
AU - Schmidt, Elisabeth
AU - Mayer, David
AU - Vock, Paul
AU - Borovac, Josip A
AU - Kwok, Chun Shing
AU - Lamm, Gudrun
AU - Mascherbauer, Julia
AU - Weiss, Thomas
N1 - Publisher Copyright:
2024 Will, Schwarz, Aufhauser, Leibundgut, Schmidt, Mayer, Vock, Borovac, Kwok, Lamm, Mascherbauer and Weiss.
PY - 2024/9
Y1 - 2024/9
N2 - Background: The benefit of chronic total occlusion (CTO)-percutaneous coronary intervention (PCI) is controversial because of a lack of high-quality evidence. We aim to evaluate the impact of CTO-PCI on symptoms, quality of life and mortality. Methods: We conducted a retrospective single center study of patients with CTO-PCI in a tertiary center in Austria. The study outcomes were Canadian Cardiovascular Society (CCS) angina score, quality of life measured by Seattle Angina Questionnaire (SAQ), and death at median follow up for patients with successful vs. failed CTO-PCI. Results: A total of 300 patients underwent CTO-PCI for coronary artery disease, of which 252 (84%) were technically successful with median follow up of 3.4 years. There were no significant differences in in-hospital or all-cause mortality, major adverse cardiovascular event, or stent-related complications between the groups of failed and successful CTO-PCI. Among patients with successful CTO-PCI there was a significant improvement in CCS score, which was not found for the group with failed CTO-PCI. Successful reopening was associated with significant benefits of the SAQ domains of angina with stressful activity [3.7 ± 0.9 vs. 3.1 ± 0.5, p = 0.004, use of nitrates (4.7 ± 0.5 vs. 3.0 ± 1.0) p = 0.005] and satisfaction from angina relief (4.4 ± 1.1 vs. 3.6 ± 1.4 p < 0.001). Conclusion: While there was no significant difference in mortality, successful CTO-PCI was associated with greater reduction in angina and the use of nitrates compared to unsuccessful CTO-PCI.
AB - Background: The benefit of chronic total occlusion (CTO)-percutaneous coronary intervention (PCI) is controversial because of a lack of high-quality evidence. We aim to evaluate the impact of CTO-PCI on symptoms, quality of life and mortality. Methods: We conducted a retrospective single center study of patients with CTO-PCI in a tertiary center in Austria. The study outcomes were Canadian Cardiovascular Society (CCS) angina score, quality of life measured by Seattle Angina Questionnaire (SAQ), and death at median follow up for patients with successful vs. failed CTO-PCI. Results: A total of 300 patients underwent CTO-PCI for coronary artery disease, of which 252 (84%) were technically successful with median follow up of 3.4 years. There were no significant differences in in-hospital or all-cause mortality, major adverse cardiovascular event, or stent-related complications between the groups of failed and successful CTO-PCI. Among patients with successful CTO-PCI there was a significant improvement in CCS score, which was not found for the group with failed CTO-PCI. Successful reopening was associated with significant benefits of the SAQ domains of angina with stressful activity [3.7 ± 0.9 vs. 3.1 ± 0.5, p = 0.004, use of nitrates (4.7 ± 0.5 vs. 3.0 ± 1.0) p = 0.005] and satisfaction from angina relief (4.4 ± 1.1 vs. 3.6 ± 1.4 p < 0.001). Conclusion: While there was no significant difference in mortality, successful CTO-PCI was associated with greater reduction in angina and the use of nitrates compared to unsuccessful CTO-PCI.
KW - chronic total occlusion (CTO)
KW - coronary artery disease (CAD)
KW - mortality
KW - percutaneous coronary intervention (PCI)
KW - quality of life
KW - symptoms
UR - http://www.scopus.com/inward/record.url?scp=85206356319&partnerID=8YFLogxK
U2 - 10.3389/fcvm.2024.1447829
DO - 10.3389/fcvm.2024.1447829
M3 - Journal article
C2 - 39399513
SN - 2297-055X
VL - 11
SP - 1447829
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
M1 - 1447829
ER -