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IMPACT OF TARGET VESSEL ON LONG-TERM CARDIAC MORTALITY AFTER SUCCESSFUL PERCUTANEOUS CORONARY INTERVENTION FOR CHRONIC TOTAL OCCLUSION; JAPANESE MULTICENTER REGISTRY
1315 JACC March 21, 2017 Volume 69, Issue 11
Interventional Cardiology IMPACT OF TARGET VESSEL ON LONG-TERM CARDIAC MORTALITY AFTER SUCCESSFUL PERCUTANEOUS CORONARY INTERVENTION FOR CHRONIC TOTAL OCCLUSION; JAPANESE MULTICENTER REGISTRY Poster Contributions Poster Hall, Hall C Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m. Session Title: Advances in Chronic Total Occlusion Intervention Abstract Category: 20. Interventional Cardiology: Coronary Intervention: CTO Presentation Number: 1282-118 Authors: Satoru Mitomo, Toru Naganuma, Kenichi Tsujita, Katsumasa Sato, Junei Obata, Tsuyoshi Kobayashi, Sunao Nakamura, New Tokyo Hospital, Chiba, Japan Background: The impact of successful chronic total occlusion (S-CTO) percutaneous coronary intervention (PCI) on cardiac mortality might be potentially different among each target CTO vessels, however yet to be adequately evaluated. The aim of this study was to investigate the impact of target vessels on cardiac mortality after S-CTO PCI.
Methods: From January 2004 to December 2011, 1517 CTO PCIs were performed in 4 Japanese centers and enrolled for this multicenter registry. Of them, 1424 CTOs with 1 main vessel CTO per patient were analyzed in this study (left anterior descending artery: LAD; 487, right coronary artery: RCA; 599, left circumflex: LCx; 338). Primary endpoint was cardiac mortality during follow-up period.
Results: Median follow-up days was 1677 (interquartile range; 811-2463) days and 92.3% of S-CTO PCI was totally obtained. In the overall population, S-CTO experienced significantly less cardiac mortality at 6-year follow-up compared with unsuccessful CTO (U-CTO) (3.3% vs. 21.3%, p<0.01). In each target CTO subgroup, cumulative cardiac mortality rate at 6-year was significantly lower after S-CTO PCI in LAD and RCA compared with U-CTO PCI (3.1% vs. 22.6%, p=0.01, 3.5% vs 32.2%, p<0.01, respectively), however not in LCx (4.3% vs 0.0%, p=0.53). Cox regression analysis demonstrated that S-CTO PCI improved cardiac mortality after CTO PCI (LAD; HR: 0.18, 95% CI: 0.060.56; p<0.01, RCA; HR: 0.24, 95% CI: 0.09-0.65; p<0.01). Conclusions: S-CTO PCI in LAD and RCA were related to lower long-term cardiac mortality after CTO PCI, whereas not in LCx.
Interventional Cardiology IMPACT OF TARGET VESSEL ON LONG-TERM CARDIAC MORTALITY AFTER SUCCESSFUL PERCUTANEOUS CORONARY INTERVENTION FOR CHRONIC TOTAL OCCLUSION; JAPANESE MULTICENTER REGISTRY Poster Contributions Poster Hall, Hall C Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m. Session Title: Advances in Chronic Total Occlusion Intervention Abstract Category: 20. Interventional Cardiology: Coronary Intervention: CTO Presentation Number: 1282-118 Authors: Satoru Mitomo, Toru Naganuma, Kenichi Tsujita, Katsumasa Sato, Junei Obata, Tsuyoshi Kobayashi, Sunao Nakamura, New Tokyo Hospital, Chiba, Japan Background: The impact of successful chronic total occlusion (S-CTO) percutaneous coronary intervention (PCI) on cardiac mortality might be potentially different among each target CTO vessels, however yet to be adequately evaluated. The aim of this study was to investigate the impact of target vessels on cardiac mortality after S-CTO PCI.
Methods: From January 2004 to December 2011, 1517 CTO PCIs were performed in 4 Japanese centers and enrolled for this multicenter registry. Of them, 1424 CTOs with 1 main vessel CTO per patient were analyzed in this study (left anterior descending artery: LAD; 487, right coronary artery: RCA; 599, left circumflex: LCx; 338). Primary endpoint was cardiac mortality during follow-up period.
Results: Median follow-up days was 1677 (interquartile range; 811-2463) days and 92.3% of S-CTO PCI was totally obtained. In the overall population, S-CTO experienced significantly less cardiac mortality at 6-year follow-up compared with unsuccessful CTO (U-CTO) (3.3% vs. 21.3%, p<0.01). In each target CTO subgroup, cumulative cardiac mortality rate at 6-year was significantly lower after S-CTO PCI in LAD and RCA compared with U-CTO PCI (3.1% vs. 22.6%, p=0.01, 3.5% vs 32.2%, p<0.01, respectively), however not in LCx (4.3% vs 0.0%, p=0.53). Cox regression analysis demonstrated that S-CTO PCI improved cardiac mortality after CTO PCI (LAD; HR: 0.18, 95% CI: 0.060.56; p<0.01, RCA; HR: 0.24, 95% CI: 0.09-0.65; p<0.01). Conclusions: S-CTO PCI in LAD and RCA were related to lower long-term cardiac mortality after CTO PCI, whereas not in LCx.