Long-Term Outcomes After Percutaneous Coronary Intervention for Chronic Total Occlusion (from the CREDO-Kyoto Registry Cohort-2)

Despite improving success rate of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions, the clinical benefit of recanalization of CTO is still a matter of debate. Of 13,087 patients who underwent PCI in the CREDO-Kyoto registry cohort-2, 1,524 patients received PCI for...

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Bibliographic Details
Published in:The American journal of cardiology 2013-09, Vol.112 (6), p.767-774
Main Authors: Yamamoto, Erika, MD, Natsuaki, Masahiro, MD, Morimoto, Takeshi, MD, Furukawa, Yutaka, MD, Nakagawa, Yoshihisa, MD, Ono, Koh, MD, Mitsudo, Kazuaki, MD, Nobuyoshi, Masakiyo, MD, Doi, Osamu, MD, Tamura, Takashi, MD, Tanaka, Masaru, MD, Kimura, Takeshi, MD
Format: Article
Language:English
Subjects:
46, XX Disorders of Sex Development
Abnormalities, Multiple
Aged
Cardiology
Cardiovascular
Cardiovascular disease
Cause of Death - trends
Congenital Abnormalities
Coronary Angiography
Coronary Occlusion - diagnosis
Coronary Occlusion - mortality
Coronary Occlusion - surgery
Female
Follow-Up Studies
Heart attacks
Hospitalization
Humans
Incidence
Japan - epidemiology
Kaplan-Meier Estimate
Kidney - abnormalities
Male
Mullerian Ducts - abnormalities
Myocardial Infarction - epidemiology
Myocardial Infarction - etiology
Percutaneous Coronary Intervention
Prognosis
Registries
Risk Assessment
Risk Factors
Somites - abnormalities
Spine - abnormalities
Stents
Survival Rate - trends
Time Factors
Treatment Outcome
Uterus - abnormalities
Vagina - abnormalities
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Summary:Despite improving success rate of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions, the clinical benefit of recanalization of CTO is still a matter of debate. Of 13,087 patients who underwent PCI in the CREDO-Kyoto registry cohort-2, 1,524 patients received PCI for CTO (CTO-PCI). Clinical outcomes were compared between 1,192 patients with successful CTO-PCI and 332 patients with failed CTO-PCI. In-hospital death tended to occur less frequently in the successful CTO-PCI group than in the failed CTO-PCI group (1.4% vs 3.0%, p = 0.053). Through 3-year follow-up, the cumulative incidence of all-cause death was not significantly different between the successful and failed CTO-PCI groups (9.0% vs 13.1%, p = 0.18), whereas the cumulative incidence of cardiac death was significantly less in the successful CTO-PCI group than in the failed CTO-PCI group (4.5% vs 8.4%, p = 0.03). However, after adjusting confounders, successful CTO-PCI was associated with lesser risk for neither all-cause death (hazard ratio 0.93, 95% confidence interval 0.64 to 1.37, p = 0.69) nor cardiac death (hazard ratio 0.71, 95% confidence interval 0.44 to 1.16, p = 0.16). The cumulative incidence of coronary artery bypass grafting (CABG) was remarkably less in patients with successful PCI compared with those with failed PCI (1.8% vs 19.6%, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2013.05.004