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Impact of multi-vessel versus single-vessel disease on outcomes after percutaneous coronary interventions for chronic

Aurel Toma1, Barbara E Stähli2, Michael Gick3

  • 1Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen Suedring 15, 79189, Bad Krozingen, Germany. toma.aurel@gmail.com.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|February 26, 2017
PubMed

Insights

Successful chronic total occlusion (CTO) revascularization improves survival. Patients with multi-vessel disease (MVD) experience a greater absolute survival benefit from CTO PCI compared to single-vessel disease (SVD) patients.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Successful revascularization of chronic total occlusions (CTOs) is linked to improved patient prognosis.
  • The impact of coronary artery disease extent on these prognostic benefits remains under-investigated.

Purpose of the Study:

  • To compare survival outcomes after percutaneous coronary intervention (PCI) for CTO in patients with multi-vessel disease (MVD) versus single-vessel disease (SVD).

Main Methods:

  • A cohort of 2002 patients undergoing CTO PCI from 2005-2013 was analyzed.
  • Patients were stratified into MVD and SVD groups.
  • The primary endpoint was all-cause mortality, with a median follow-up of 2.6 years.

Main Results:

  • Multi-vessel disease (MVD) was present in 81.6% of patients.
  • Procedural success rates were 81.5% for MVD and 89.7% for SVD.
  • All-cause mortality was higher in MVD patients (13.5%) vs. SVD patients (5.7%), but the survival benefit of successful CTO PCI was consistent across both groups, with a larger absolute benefit observed in MVD patients due to higher baseline risk.

Conclusions:

  • Successful CTO recanalization is an independent predictor of reduced long-term mortality.
  • While the relative survival benefit is similar, the absolute survival benefit following successful CTO PCI is substantially greater in patients with MVD compared to those with SVD.
Abstract

Keywords:
Chronic total occlusionCoronary artery diseaseMulti-vessel diseasePercutaneous coronary interventionSingle-vessel disease

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