CBS 2019
CBSMD教育中心
中 文

Other Relevant Articles

Abstract

Recommended Article

Utilization and programming of an automatic MRI recognition feature for cardiac rhythm management devices Prospective Elimination of Distal Coronary Sinus to Left Atrial Connection for Atrial Fibrillation Ablation (PRECAF) Randomized Controlled Trial Development and validation of a simple risk score to predict 30-day readmission after percutaneous coronary intervention in a cohort of medicare patients Randomized Trial Evaluating Percutaneous Coronary Intervention for the Treatment of Chronic Total Occlusion: The DECISION-CTO Trial The HACD4 haplotype as a risk factor for atherosclerosis in males Cholesterol-Lowering Agents Percutaneous Recanalization of Chronic Total Occlusions: 2019 Consensus Document from the EuroCTO Club From Nonclinical Research to Clinical Trials and Patient-registries: Challenges and Opportunities in Biomedical Research
|<<... 3 4 5 6 7 8 9 ...>>|

Clinical TrialPublished on 26 September 2017

JOURNAL：EuroIntervention. Article Link

Clinical Implications of Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention for Chronic Total Occlusion: Role of Antegrade and Retrograde Crossing Techniques

Toma A, Stähli B, Gebhard C et al. Keywords: myocardial infarction; stable angina; death; Chronic coronary total occlusion

ABSTRACT

AIMS - Periprocedural myocardial injury (PMI) is frequently observed after percutaneous coronary interventions (PCI) for chronic total occlusion (CTO). We investigated the prognostic impact of PMI with the antegrade or the retrograde crossing technique.


METHODS AND RESULTS - A total of 1909 patients undergoing CTO PCI were stratified according to the presence/absence of PMI (elevation of cardiac troponin T [cTnT] >5x 99th percentile of normal), and divided according to tertiles of the difference between peak and baseline cTnT within 24 hours (ΔcTnT). The primary endpoint was all-cause mortality at a median follow-up of 3.1 (interquartile range 3.0-4.4) years. PMI occurred in 19.4% and 25.4% after antegrade (n=1447) and retrograde (n=462) procedures (p<0.001). PMI was significantly associated with mortality after antegrade (adjusted HR 1.39, 95% CI 1.02-1.88, p=0.04), but not retrograde CTO PCI (adjusted HR 0.93,95% CI 0.53-1.63, p=0.80, Pint=0.02). With the antegrade, but not the retrograde approach, mortality also increased with tertiles of ΔcTnT (T1: 11.0%, T2: 18.6%, T3: 21.6%, Log Rank p<0.001).


CONCLUSIONS - Periprocedural myocardial injury was significantly associated with all-cause mortality following antegrade, but not retrograde CTO PCI. Hence, the higher risk of PMI following retrograde procedures did not translated into worse survival.

>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top