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Predictors of Adverse Events Among Chronic Total Occlusion Patients Undergoing Successful Percutaneous Coronary

Le Yang1,2, Lei Guo1, Haichen Lv1

  • 1Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, People's Republic of China.

Clinical Interventions in Aging
|October 27, 2021
PubMed

Insights

Heart failure predicts major adverse cardiac events (MACE) after successful coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Male gender, diabetes, heart failure, J-CTO score, and multivessel disease also predict MACE in CTO patients receiving medical therapy.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • Major adverse cardiac events (MACE) following coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) require further investigation.
  • Limited data exist on predictors of MACE in patients with CTO undergoing successful PCI and medical therapy.

Purpose of the Study:

  • To identify predictors of MACE in patients with CTO after successful recanalization and medical therapy.
  • To analyze risk factors associated with MACE in CTO patients undergoing PCI.
  • To compare MACE predictors between successful CTO PCI and medical therapy groups.

Main Methods:

  • A cohort of 2015 patients with CTOs was analyzed.
  • Patients were divided into two groups: successful CTO recanalization (718 patients) and medical therapy (1297 patients).
  • Multivariate models identified predictors of MACE, defined as cardiac death, myocardial infarction, or target-vessel revascularization.

Main Results:

  • In the successful CTO PCI group, MACE occurred in 17.1% of patients. Heart failure was an independent predictor of MACE (HR 1.77).
  • In the medical therapy group, predictors of MACE included male gender (HR 1.53), diabetes mellitus (HR 1.39), heart failure (HR 1.44), J-CTO score (HR 1.17), and multivessel disease (HR 2.20).

Conclusions:

  • Heart failure is a significant predictor of MACE in patients with CTO following successful PCI.
  • Male gender, diabetes mellitus, heart failure, J-CTO score, and multivessel disease are key predictors of MACE in CTO patients managed with medical therapy.
Abstract

Keywords:
MACEcoronary chronic total occlusionsmedical therapypercutaneous coronary interventionpredictors

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