Comparison of successful percutaneous coronary intervention versus optimal medical therapy in patients with coronary chronic total occlusion

被引：19

作者：

Choo, Eun Ho ^{[1
]}

Koh, Yoon-Seok ^{[2
]}

Seo, Suk Min ^{[2
]}

Lee, Jong Min ^{[1
]}

Kim, Hee Yeol ^{[3
]}

Park, Hun-Jun ^{[2
]}

Kim, Pum-Joon ^{[2
]}

Chang, Kiyuk ^{[2
]}

Jeon, Doo Soo ^{[4
]}

Kim, Dong Bin ^{[5
]}

Her, Sung-Ho ^{[6
]}

Park, Chul Soo ^{[7
]}

Yoo, Ki-Dong ^{[8
]}

Chung, Wook Sung ^{[2
]}

Seung, Ki-Bae ^{[2
]}

机构：

[1] Catholic Univ Korea, Uijeongbu St Marys Hosp, Dept Internal Med, Div Cardiol, Uijengbu, South Korea

[2] Catholic Univ Korea, Seoul St Marys Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea

[3] Catholic Univ Korea, Bucheon St Marys Hosp, Dept Internal Med, Div Cardiol, Bucheon, South Korea

[4] Catholic Univ Korea, Incheon St Marys Hosp, Dept Internal Med, Div Cardiol, Incheon, South Korea

[5] Catholic Univ Korea, St Pauls Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea

[6] Catholic Univ Korea, Daejeon St Marys Hosp, Dept Internal Med, Div Cardiol, Daejeon, South Korea

[7] Catholic Univ Korea, Yeouido St Marys Hosp, Dept Internal Med, Div Cardiol, Seoul, South Korea

[8] Catholic Univ Korea, St Vincents Hosp, Dept Internal Med, Div Cardiol, Suwon, South Korea

来源：

JOURNAL OF CARDIOLOGY | 2019年 / 73卷 / 1-2期

关键词：

Chronic total occlusion; Percutaneous coronary intervention; Drug-eluting stent; LEFT-VENTRICULAR FUNCTION; LONG-TERM OUTCOMES; CLINICAL-OUTCOMES; TASK-FORCE; RECANALIZATION; REVASCULARIZATION; ASSOCIATION; METAANALYSIS; ANGIOPLASTY; IMPROVEMENT;

D O I：

10.1016/j.jjcc.2018.08.006

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Chronic total occlusion (CTO) is a challenging entity in coronary interventions. With improvements in technology and techniques, success rates for percutaneous coronary intervention (PCI) of CTO continue to improve. However, the clinical benefits of PCI remain unclear. The aim of the study was to determine the effectiveness of successful PCI on clinical outcomes using drug-eluting stents in patients with CTO. Methods: From 2004 to 2010, we analyzed 898 patients with at least one CTO who underwent successful PCI (n = 424, 448 lesions) or only medical treatment (n = 474, 519 lesions) from a multicenter registry. The primary outcome was all-cause death. Results: During a median of 2.2 years, incidence rate of all-cause death after successful PCI was lower than that after medical treatment (10.6% and 17.5%, p = 0.004). However, the multivariate Cox proportional hazards model showed that successful PCI was not associated with improvement in mortality compared to medical treatment [adjusted hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.57-1.24, p = 0.38]. Comparable results were obtained after propensity-score matching. Subgroup analysis of propensity-score matched population demonstrated that patients with age under 65 years benefited from successful PCI (HR 0.25, 95% CI 0.08-0.75, p for interaction = 0.005). Conclusions: In patients considered for CTO intervention, medical treatment appears to be associated with a similar mortality compared to successful PCI. Successful CTO PCI might be associated with survival benefit in younger patients compared to medical treatment. (C) 2018 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

引用

页码：156 / 162

页数：7

共 29 条

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