TY - JOUR
T1 - Follow-up outcomes after chronic total occlusion percutaneous coronary intervention in patients with and without prior coronary artery bypass graft surgery
T2 - Insights from the progress-cto registry
AU - Nikolakopoulos, Ilias
AU - Choi, James W.
AU - Khatri, Jaikirshan J.
AU - Alaswad, Khaldoon
AU - Doing, Anthony H.
AU - Dattilo, Phil
AU - Rafeh, Nidal Abi
AU - Maalouf, Assaad
AU - Jaoudeh, Fadi Abou
AU - Tamez, Hector
AU - Shah, Alpesh
AU - Gkargkoulas, Fotis
AU - Lembo, Nicholas J.
AU - Parikh, Manish
AU - Kirtane, Ajay J.
AU - Ali, Ziad A.
AU - Vemmou, Evangelia
AU - Xenogiannis, Iosif
AU - Rangan, Bavana V.
AU - Abdullah, Shuaib
AU - Banerjee, Subhash
AU - Garcia, Santiago
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
AU - Karmpaliotis, Dimitri
N1 - Publisher Copyright:
© 2020 HMP Communications. All rights reserved.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - BACKGROUND: Long-term outcomes of patients with prior coronary artery bypass graft (CABG) surgery undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have received limited study.METHODS: We compared the clinical and angiographic characteristics and procedural and follow-up outcomes of patients with and without prior CABG in a multicenter international registry.RESULTS: Of the 1572 patients included in this analysis, a total of 498 (32%) had prior CABG. Prior CABG patients had higher J-CTO scores (2.9 ± 1.1 vs 2.2 ± 1.3; P<.001) and were less likely to undergo PCI of the left anterior descending artery (16.7% vs 29.6%; P<.001). The retrograde technique was used more often (47.4% vs 28.2%; P<.001) and was successful more often (27.4% vs 17.1%; P<.001) in the prior CABG group vs the non-prior CABG group. Technical success was lower in prior CABG patients (82.6% vs 87.9%; P<.01) with similar incidence of in-hospital major adverse cardiovascular events (3.4% vs 3%; P=.65), although in-hospital mortality was higher in the prior CABG group (2.4% vs 1.0%; P=.04). At 1-year follow-up, the composite endpoint of death, myocardial infarction, and revascularization was higher in prior CABG patients (21.79% vs 12.73%; hazard ratio, 1.76; 95% confidence interval, 1.27-2.45; P<.001).CONCLUSION: Compared with non-prior CABG patients, prior CABG patients undergoing CTO-PCI had lower technical success and higher incidence of acute and follow-up adverse cardiovascular events.
AB - BACKGROUND: Long-term outcomes of patients with prior coronary artery bypass graft (CABG) surgery undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have received limited study.METHODS: We compared the clinical and angiographic characteristics and procedural and follow-up outcomes of patients with and without prior CABG in a multicenter international registry.RESULTS: Of the 1572 patients included in this analysis, a total of 498 (32%) had prior CABG. Prior CABG patients had higher J-CTO scores (2.9 ± 1.1 vs 2.2 ± 1.3; P<.001) and were less likely to undergo PCI of the left anterior descending artery (16.7% vs 29.6%; P<.001). The retrograde technique was used more often (47.4% vs 28.2%; P<.001) and was successful more often (27.4% vs 17.1%; P<.001) in the prior CABG group vs the non-prior CABG group. Technical success was lower in prior CABG patients (82.6% vs 87.9%; P<.01) with similar incidence of in-hospital major adverse cardiovascular events (3.4% vs 3%; P=.65), although in-hospital mortality was higher in the prior CABG group (2.4% vs 1.0%; P=.04). At 1-year follow-up, the composite endpoint of death, myocardial infarction, and revascularization was higher in prior CABG patients (21.79% vs 12.73%; hazard ratio, 1.76; 95% confidence interval, 1.27-2.45; P<.001).CONCLUSION: Compared with non-prior CABG patients, prior CABG patients undergoing CTO-PCI had lower technical success and higher incidence of acute and follow-up adverse cardiovascular events.
KW - Chronic total occlusion
KW - Coronary artery bypass graft surgery
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M3 - Article
C2 - 32428867
AN - SCOPUS:85089126071
SN - 1042-3931
VL - 32
SP - 315
EP - 320
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 8
ER -