Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents.

Abstract:

BACKGROUND:The aim of this study was to identify the prognostic predictors for the worse clinical outcomes after a successful chronic total occlusion (CTO) intervention with drug-eluting stents. PATIENTS AND RESULTS:A total of 2334 patients in the multicenter Korean CTO registry who underwent a successful CTO intervention with drug-eluting stents (first generation, 1367, new generation, 967) were enrolled. The primary endpoint was the composite of cardiac death, myocardial infarction, and stent thrombosis.The cumulative incidence of the primary endpoint was 2.5% (median follow-up duration: 22 months). In multivariate analysis, age above 65 years [hazard ratio (HR)=1.769, 95% confidence interval (CI)=1.025-3.052, P=0.041], heart failure (HR=4.242, 95% CI=2.335-7.705, P<0.001), and diabetes (HR=1.773, 95% CI=1.043-3.012, P=0.034) were the significant predictors. The cumulative incidence of the primary endpoint was significantly higher in patients with three risk factors (19.1%) than in those with one (2.2%) or two (3.0%) risk factors (P=0.001). The cumulative target-vessel revascularization rate was 8.4%, with the significant predictors being a diffuse long lesion (HR=1.626, 95% CI=1.129-2.340, P=0.009) and at least three implanted stents (HR=1.964, 95% CI=1.301-2.965, P=0.001). CONCLUSION:Clinical parameters such as age, diabetes, and heart failure were independent predictors of the composite of cardiac death, myocardial infarction, and stent thrombosis, whereas angiographic or procedural parameters such as lesion length and number of implanted stents were predictors of target-vessel revascularization. Clinical outcomes after CTO intervention were worse in patients with multiple risk factors.

journal_name

Coron Artery Dis

journal_title

Coronary artery disease

authors

Kim GS,Kim BK,Shin DH,Kim JS,Hong MK,Gwon HC,Kim HS,Yu CW,Park HS,Chae IH,Rha SW,Jang Y,K-CTO Registry.

doi

10.1097/MCA.0000000000000498

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

381-386

issue

5

eissn

0954-6928

issn

1473-5830

journal_volume

28

pub_type

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