Document Detail

Improved cardiac survival, freedom from mace and angina-related quality of life after successful percutaneous recanalization of coronary artery chronic total occlusions.
MedLine Citation:
PMID:  21722979     Owner:  NLM     Status:  Publisher    
BACKGROUND: Most percutaneous recanalizations of coronary artery chronic total occlusion (CTO) are not attempted because of the skepticism on their long-term clinical benefit. We assessed the effect of percutaneous CTO recanalization procedures on long-term cardiac survival, freedom from MACE and angina-related quality of life (AQL). METHODS: All consecutive patients who underwent attempt of percutaneous native coronary artery CTO recanalization between 2003 and 2009 were included in the study. MACE was defined as combined cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR). AQL was assessed by the Seattle Angina Questionnaire-UK-version (SAQ-UK). RESULTS: Among 302 patients who received an attempt of percutaneous CTO recanalization, 237 (78%) had a successful procedure while in 65 (22%) the procedure failed. Overall intra-hospital complication rate was 3.0%, with no difference between the two groups. Median follow-up was 4.0years, during which 13 patients had a fatal cardiac event. Patients in whom the CTO recanalization procedure failed had a higher risk of cardiac death (HR 3.39; 95% CI 1.14-10.1;p=0.03; after propensity score adjustment, HR 2.83; 95% CI 0.89-8.96;p=0.07) and MACE (HR 5.40; 95% CI 2.71-10.5;p<0.001; adjusted HR 3.34; 95% CI 1.47-7.58;p=0.003) compared to patients with successful procedure. CTO recanalization significantly improved the AQL during follow-up: patients with successful procedure experienced less physical activity limitation (p=0.01), rarer angina episodes (p<0.001) and greater treatment satisfaction (p=0.03) compared to patients with failed procedure. CONCLUSIONS: Patients with successful CTO recanalization had a trend towards better cardiac survival and significant lower risk of MACE and improvement of AQL compared to patients with failed procedures.
Francesco Borgia; Nicola Viceconte; Omar Ali; Claire Stuart-Buttle; Anjana Saraswathyamma; Rosario Parisi; Francesca Mirabella; Konstantinos Dimopoulos; Carlo Di Mario
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-30
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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