| Meta-analysis of effect on mortality of percutaneous recanalization of coronary chronic total occlusions using a stent-based strategy. | |
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MedLine Citation:
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PMID: 23375252 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We performed a systematic review and meta-analysis comparing the all-cause mortality outcomes of successful percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) with unsuccessful CTO-PCI, using a stent-based strategy. Multiple studies comparing successful CTO-PCI with unsuccessful CTO-PCI have reported variable outcomes. No systematic review or meta-analysis has been performed after stenting became the default strategy for CTO-PCI. Searching major electronic databases, 64 studies were identified using the keywords "CTO," "PCI," and "mortality." Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method, 13 studies met the criteria for inclusion in the present meta-analysis. The short-term (≤30 days) and long-term (≥1 year) mortality outcomes were analyzed comparing successful CTO-PCI and unsuccessful CTO-PCI. Coronary perforation and its association with CTO-PCI success was analyzed. A significant reduction in short-term mortality was noted with successful CTO-PCI compared to unsuccessful CTO-PCI (odds ratio 0.218, 95% confidence interval 0.095 to 0.498, Z = -3.61, p <0.001). A similar, significant reduction in long-term mortality was noted with successful CTO-PCI compared to unsuccessful CTO-PCI (odds ratio 0.391, 95% confidence interval 0.311 to 0.493, Z = -7.957, p <0.001). A significant association was present between coronary perforation and unsuccessful CTO-PCI (odds ratio 0.168, 95% confidence interval 0.104 to 0.271, Z = -7.333, p <0.001). In conclusion, successful CTO-PCI using a predominantly stent-based strategy is associated with a significant reduction in short- and long-term mortality compared to unsuccessful CTO-PCI. Coronary perforation was associated with CTO-PCI failure. |
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Authors:
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Samir B Pancholy; Pranjal Boruah; Imdad Ahmed; Tak Kwan; Tejas M Patel; Shigeru Saito |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 111 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-02-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 521-5 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2013. Published by Elsevier Inc. |
Affiliation:
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Cardiovascular Diseases, The Wright Center for Graduate Medical Education and Medicine, The Commonwealth Medical College, Scranton, Pennsylvania. Electronic address: pancholys@gmail.com. |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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