Document Detail

Percutaneous coronary interventions and cardiovascular outcomes for patients with chronic total occlusions.
MedLine Citation:
PMID:  21805595     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study sought to assess the benefits of a coronary chronic total occlusion CTO recanalization after adjusting for the case-mix and the propensity to undergo the CTO intervention in a population of patients with stable coronary artery disease.
BACKGROUND: The benefits of percutaneous recanalization of CTO are disputed.
METHODS: In 1,602 patients with a least one CTO and treated by percutaneous coronary intervention (PCI), we derived a propensity score to undergo a CTO recanalization by comparing the characteristics of patients who did (n = 346) and did not (n = 1,256) undergo a CTO PCI attempt. Among the patients who underwent a CTO PCI attempt, we identified the angiographic predictors of failure. The primary analysis was ultimately performed by looking at the association between the outcome of the CTO recanalization and the survival free of death and cardiovascular rehospitalizations. Sensitivity analyses were performed by adjusting for the propensity to undergo a CTO recanalization, for the anatomical predictors of failure, and for the extent of coronary artery revascularization achieved.
RESULTS: A successful CTO recanalization was not significantly associated with survival free of death and cardiovascular rehospitalization (HR = 0.90, 95% CI 0.64-1.25). Even more conservative hazards ratio point estimates were obtained with the sensitivity analyses.
CONCLUSIONS: Successful percutaneous CTO recanalization is not associated with survival free of death and cardiovascular hospitalizations in a contemporary population of patients with symptomatic coronary artery disease.
E Marc Jolicœur; Micheal J Sketch; Daniel M Wojdyla; Sean P Javaheri; Shravan Nosib; Yuliya Lokhnygina; Manesh R Patel; Linda K Shaw; James E Tcheng
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-12-12
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  79     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-20     Completed Date:  2012-06-12     Revised Date:  2012-08-23    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  603-12     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
Duke University Medical Center, Durham, North Carolina, USA.
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MeSH Terms
Angioplasty, Balloon, Coronary / adverse effects*,  mortality
Cardiovascular Diseases / etiology*,  mortality,  therapy
Chi-Square Distribution
Chronic Disease
Coronary Angiography
Coronary Occlusion / mortality,  radiography,  therapy*
Disease-Free Survival
Logistic Models
Middle Aged
Multivariate Analysis
North Carolina
Patient Readmission
Predictive Value of Tests
Propensity Score
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Comment In:
Catheter Cardiovasc Interv. 2012 Mar 1;79(4):613-4   [PMID:  22344993 ]
Catheter Cardiovasc Interv. 2012 Jul 1;80(1):151-3   [PMID:  22422510 ]

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