Complete vs. incomplete percutaneous revascularization in patients with chronic total coronary artery occlusion

• DOI: 10.3389/fcvm.2024.1443258
• Publication Date: 2024-07-23T04:46:21Z
• Authors: Luis Carlos Maest...; Rafael Gonzalez-M...; Javier Suárez de ...; Francisco Hidalgo; Lucas Barreiro-Mesa; Jaime de Juan; Ignacio Gallo; Jorge Perea; Marco Alvarado; Miguel Romero; Soledad Ojeda; Manuel Pan
• Keywords: 03 medical and health sciences; myocardial infarction; 0302 clinical medicine; RC666-701; percutaneous coronary intervention; Diseases of the circulatory (Cardiovascular) system; Cardiovascular Medicine; chronic total occlusion; major adverse cardiovascular events; coronary artery disease

Introduction There is current controversy surrounding the benefits of percutaneous coronary intervention (PCI) chronic total occlusions (CTO). We aimed to evaluate impact complete revascularization on major adverse cardiovascular events (MACE) in patients with CTO. Methods A retrospective observational study was conducted consecutive referred for invasive angiography at a single center between January 2018 and December 2019 least The were divided into two groups according result procedure: CTO (CR-CTO) versus incomplete (ICR-CTO) (patients one non-recanalized CTO). Short- mid-term clinical outcomes evaluated. primary endpoint composite MACE that included all-cause death, non-fatal myocardial infarction, stroke, or unplanned revascularization. Results In total, 359 included. median age 68 years [interquartile range (IQR) 60–77 years], 66 (18%) women 169 (47.3%) had diabetes mellitus. all, 167 (46.5%) received After follow-up 42 months (IQR 46–50 months), occurred 39 (23.4%) CR-CTO group 75 (39.1%) ICR-CTO (HR 0.50, 95% CI 0.34–0.74; p < 0.001). This association remained significant an inverse probability weighted model considering prognostic factors (adjusted HR 0.61, 0.41–0.92; = 0.018) driven by lower rates death OR 0.23–0.84; 0.01). Conclusions Complete associated risk midterm follow up.