CBS 2019
CBSMD教育中心
English

Acute Coronary Syndrom

科研文章

荐读文献

Transition of Macrophages to Fibroblast-Like Cells in Healing Myocardial Infarction Complete or Culprit-Only Revascularization for Patients With Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Pairwise and Network Meta-Analysis of Randomized Trials Subcutaneous Selatogrel Inhibits Platelet Aggregation in Patients With Acute Myocardial Infarction Management of Myocardial Revascularization Failure: An Expert Consensus Document of the EAPCI Effect of Lipoprotein (a) Levels on Long-term Cardiovascular Outcomes in Patients with Myocardial Infarction with Nonobstructive Coronary Arteries Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation: A Systematic Review and Meta-Analysis Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study Canadian Multicenter Chronic Total Occlusion Registry: Ten-Year Follow-Up Results of Chronic Total Occlusion Revascularization Chronic Kidney Disease and Coronary Artery Disease Mortality in STEMI patients without standard modifiable risk factors: a sex-disaggregated analysis of SWEDEHEART registry data

Original Research2018 Oct 6. pii: S1885-5857(18)30360-8.

JOURNAL:Rev Esp Cardiol (Engl Ed). Article Link

Impact of Chronic Total Coronary Occlusion Location on Long-term Survival After Percutaneous Coronary Intervention

Ahn JH, Yang JH, Choi SH et al. Keywords: CTO; OMT; proximal or middle left anterior descending artery;

ABSTRACT


INTRODUCTION AND OBJECTIVES - Limited data are available on the clinical outcomes of optimal medical therapy (OMT) compared with revascularization by percutaneous coronary intervention (PCI) in patients with chronic total coronary occlusion (CTO) of the proximal or middle left anterior descending artery (pmLAD). Therefore, the objective of this study was to compare the long-term outcomes of patients with pmLAD CTO who were treated with a PCI strategy with those of patients treated with an OMT strategy.


METHODS - Between March 2003 and February 2012, 2024 patients with CTO were enrolled in a single-center registry. Among this patient group, we excluded CTO patients who underwent coronary artery bypass grafting. After the exclusion, a total of 1547 patients remained. They were stratified according to classification of coronary segments (pmLAD or non-pmLAD CTO) and the initial treatment strategy (OMT or PCI). Propensity score matching was performed. The primary outcome was cardiac death.


RESULTS - The median follow-up was 45.9 (interquartile range, 22.9-71.1) months. After propensity score matching, the incidence of cardiac death (HR, 0.54; 95%C, 0.31-0.94, P=.029) was significantly lower in the PCI with pmLAD CTO group than in the OMT group. In contrast, no significant difference was found in the rate of cardiac death between the PCI and OMT groups with non-pmLAD CTO (HR, 0.62; 95%CI, 0.27-1.42, P=.26).


CONCLUSIONS - As an initial treatment strategy, PCI of pmLAD CTO, but not PCI of non-pmLAD, is associated with improved long-term survival.

 

Copyright © 2018. Published by Elsevier España, S.L.U.