Author + information
- Mahboob Alam,
- Khaleeq H. Siddiqui,
- Salman Bandeali,
- Salim Virani,
- Hani Jneid,
- Rajiv Goswami,
- Christie Ballantyne,
- Neal Kleiman and
- Nasser Lakkis
The impact of successful CTO recanalization on short and long term survival remains unclear. We conducted a meta–analysis to assess the impact of successful CTO recanalization on clinical outcomes.
An extensive literature search till 8/30/2012 identified 16 studies comparing successful (sCTO) and unsuccessful (uCTO) PCI. Clinical outcomes of interest include all–cause and cardiac mortality, MI, MACE, recurrent angina, CABG and repeat revascularization assessed as in–hospital and at long term follow–up. Meta–analysis was performed using random effects model (Review Manager 5.1).
These 16 studies reported clinical outcomes in 11,797 patients (sCTO=8464, uCTO=3333). The two groups were similar in terms of age, HTN, DM, HLD, CRI, prior stroke and LV ejection fraction. Patients in the uCTO group had higher rate of complications [coronary perforation (6.6% vs. 1.0%) & coronary dissection (14.3% vs. 9.5%), p<0.01]. Successful CTO PCI was associated with lower in–hospital & long term (57.3 months) rates of cardiac & all–cause mortality, MACE and need for CABG. Patients in sCTO group had reduced recurrent angina & higher rate of repeat revascularization at long term follow–up (Table).
Successful CTO PCI is associated with short and long term reduction in cardiac and all–cause mortality as well as lower risk of angina and subsequent CABG. CTO PCI should be performed by experienced operators as a failed attempt is associated with higher risk of complications.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Chronic Total Occlusions
Abstract Category: 44. TCT@ACC–i2: Coronary Intervention, CTO
Presentation Number: 2103M–232
- 2013 American College of Cardiology Foundation