Abstract:
BACKGROUND:Chronic total occlusion (CTO) recanalizations remain extremely challenging procedures. With improvements in technology and techniques, success rates for recanalization of CTO continue to improve. However, the clinical benefits of this practice remain unclear. The aim of the study was to determine the effectiveness of CTO recanalization on clinical outcomes. METHODS:We performed a systematic review and meta-analysis of published studies comparing CTO recanalization to medical management. Data were extracted in duplicate and analyzed by a random effects model. RESULTS:We did not identify any randomized controlled trials or observational studies comparing CTO recanalization to a planned medical management. We did identify 13 observational studies comparing outcomes after successful vs failed CTO recanalization attempt. These studies encompassed 7,288 patients observed over a weighted average follow-up of 6 years. There were 721 (14.3%) deaths of 5,056 patients after successful CTO recanalization compared to 390 deaths (17.5%) of 2,232 patients after failed CTO recanalization (odds ratio [OR] 0.56, 95% CI 0.43-0.72). Successful recanalization was associated with a significant reduction in subsequent coronary artery bypass graft surgery (CABG) (OR 0.22, 95% CI 0.17-0.27) but not in myocardial infarction (OR 0.74, 95% CI 0.44-1.25) or major adverse cardiac events (OR 0.81, 95% CI 0.55-1.21). In the 6 studies that reported angina status, successful recanalization was associated with a significant reduction in residual/recurrent angina (OR 0.45, 95% CI 0.30-0.67). CONCLUSIONS:In highly selected patients considered for CTO recanalization, successful attempts appear to be associated with an improvement in mortality and with a reduction for the need for CABG as compared to failed recanalization. However, given the observational nature of the reviewed evidence, randomized clinical trials are needed to confirm these findings.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Joyal D,Afilalo J,Rinfret Sdoi
10.1016/j.ahj.2010.04.015subject
Has Abstractpub_date
2010-07-01 00:00:00pages
179-87issue
1eissn
0002-8703issn
1097-6744pii
S0002-8703(10)00343-1journal_volume
160pub_type
杂志文章,meta分析,评审abstract::This study uses echocardiography to characterize the pattern of left ventricular hypertrophy in a new hypertensive heart failure-prone rat strain designated SHHF/Mcc-cp (SHHF). M-mode echocardiograms of the left ventricle in nine 10- to 12-month old SHHF rats and nine age-matched spontaneously hypertensive rats (SHR) ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90081-0
更新日期:1995-10-01 00:00:00
abstract::Thirty cases of paradoxical embolism are reviewed to consolidate clinical presentations and common predisposing factors. The presence of patent foramen ovale in the great majority of these patients in association with maneuvers that transiently elevate right atrial pressure is emphasized in relation to the pathophysio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90692-7
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND:The 2020 American Heart Association Impact Goal aims to improve cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular disease and stroke by 20%. A large step toward this goal would be to better understand and take advantage of the significant intersection between behavior an...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
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更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a recently recognized condition where biomarkers and prognosis are less well studied than in MI with obstructive coronary artery disease (MI-CAD). We therefore aimed to investigate the one-year prognostic value of high-sensitivity ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2018.03.005
更新日期:2018-06-01 00:00:00
abstract::We tested whether overload of the two ventricles may be associated with a preponderance of interventricular septum in patients with high blood pressure. The rationale is that the septum is shared by the greater and lesser circulation and that in hypertension the latter shows the same qualitative hemodynamic alteration...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90626-6
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pub_type: 杂志文章,评审
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abstract:BACKGROUND:Case fatality rates after acute myocardial infarction (MI) have decreased markedly over the last 3 decades. Some subgroups may have benefited more than others, but this hypothesis has not been evaluated in a large nationally representative cohort. Accordingly, we sought to assess long-term temporal trends in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.04.009
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:Implantation of drug-eluting stents has emerged as the predominant percutaneous revascularization strategy in diabetic patients, despite limited outcomes data. Accordingly, our aim was to conduct a meta-analysis to assess the benefit and safety profile of drug-eluting stents in diabetic patients. METHODS:We ...
journal_title:American heart journal
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.ahj.2007.11.017
更新日期:2008-04-01 00:00:00
abstract:CLINICAL SCENARIO:A 67-year-old man is referred to your cardiology clinic complaining of worsening angina and dyspnea on exertion. Physical examination reveals a harsh grade IV/VI late-peaking crescendo-decresendo systolic murmur, loudest at the upper sternal border. The aortic closure sound is diminished. Echocardiogr...
journal_title:American heart journal
pub_type: 杂志文章
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90308-7
更新日期:1980-01-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70280-7
更新日期:1998-04-01 00:00:00
abstract::Angina pectoris before and after MI was evaluated in a sample of 729 men and women from a general population in whom MI developed during a 36-year period of follow-up. Relations of AP to subsequent CHD events and mortality after initial MI were analyzed by proportional hazards regression models and were adjusted for c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(96)90406-8
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Congestive heart failure (CHF) and heart transplantation (HTX) are characterized by endothelial dysfunction as indicated by elevation of markers of endothelial function, including endothelin and von Willebrand factor (vWF). However, previous studies included both patients with idiopathic dilated cardiomyopat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70505-3
更新日期:1999-03-01 00:00:00
abstract::The effects of cytochrome C, an electron carrier in the process of oxidative phosphorylation, on infarct size and regional left ventricular function after a coronary artery occlusion were investigated. Thus, in 30 dogs, 1 minute after left anterior descending coronary artery occlusion, 99mTc-labeled albumin microspher...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90019-6
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Recently, long (> or =20 mm) coronary stents were introduced for clinical use. They are intended as an alternative to multiple conventional stents to treat extensive dissections or suboptimal results of long lesions after balloon angioplasty. METHODS:In a total of 113 such consecutive vessels in 107 patient...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1053/hj.1998.v136.89578
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:AutoCapture (AC) is a programmable feature that enables the pacemaker to both track the capture threshold and automatically adjust the output on a beat-by-beat basis. Although AC safely and significantly reduces the current drainage, some authors have argued that the longevity benefit of such a system is ove...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00529-5
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Although hospital admissions during weekends have been associated with worse quality of care and worse outcomes in some but not all medical conditions, the impact of weekend versus weekday admission and discharge for heart failure (HF) has not been well studied. This study investigates the association of (1)...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.06.025
更新日期:2009-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.03.009
更新日期:2007-06-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1997-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1993-08-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1982-10-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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更新日期:2006-10-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2012.08.003
更新日期:2012-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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journal_title:American heart journal
pub_type: 杂志文章,评审
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更新日期:1988-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1991-09-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章
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