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PERCUTANEOUS CORONARY INTERVENTION OF CORONARY CHRONIC TOTAL OCCLUSIONS IMPROVES PEAK OXYGEN UPTAKE DURING CARDIOPULMONARY EXERCISE TESTING
1318 JACC March 21, 2017 Volume 69, Issue 11
Interventional Cardiology PERCUTANEOUS CORONARY INTERVENTION OF CORONARY CHRONIC TOTAL OCCLUSIONS IMPROVES PEAK OXYGEN UPTAKE DURING CARDIOPULMONARY EXERCISE TESTING 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: 1282-121 Authors: Shuaib Abdullah, Jeffrey Hastings, Suwetha Amsavelu, Francisco Garcia-Morales, Fury Hendrix, Aris Karatasakis, Barbara Danek, Judit Karacsonyi, Bavana Rangan, Michele Roesle, Houman Khalili, Subhash Banerjee, Emmanouil Brilakis, VA North Texas Medical Center, Dallas, TX, USA, University of Texas Southwestern Medical Center, Dallas, TX, USA Background: Although coronary chronic total occlusions (CTOs) are treated with percutaneous coronary intervention (PCI) to improve symptoms, studies demonstrating improvement in objective measures, such as peak oxygen uptake (V̇O2), are limited.
Methods: Patients referred for CTO PCI were prospectively enrolled. The primary outcome was improvement in peak V̇O2 during cardiopulmonary exercise (CPX) testing 5 months after CTO PCI. Secondary outcomes included improvement in physical capacity and angina, as assessed by questionnaires, and in plasma brain natriuretic peptide (BNP) levels.
Results: CTO PCI was attempted in 32 men (mean age 62; CTO vessel: 47% RCA; 44% LAD). In 1 patient CTO PCI was unsuccessful, and 3 patients had restenosis of their CTO vessel at follow-up. In the 28 patients with patent CTO vessel at follow-up, significant improvements were noted in self-reported physical capacity and angina. In the 27 patients who underwent baseline and follow-up CPX testing, peak V̇O2 significantly improved from 17.7 ± 4.3 ml/kg/min to 19.1 ± 4.0 ml/kg/min (p=0.02) among the 25 patients with patent CTO vessel, while in the 2 patients with restenosis, peak V̇O2 decreased (Figure). Plasma BNP levels significantly decreased from 143 ± 138 pg/ ml to 102 ± 123 pg/ml (p=0.01). Conclusions: CTO PCI in symptomatic patients was associated with improvements in cardiovascular exercise capacity, as assessed by peak V̇O2. These results suggest that in symptomatic patients with CTOs, PCI appears clinically beneficial.
Interventional Cardiology PERCUTANEOUS CORONARY INTERVENTION OF CORONARY CHRONIC TOTAL OCCLUSIONS IMPROVES PEAK OXYGEN UPTAKE DURING CARDIOPULMONARY EXERCISE TESTING 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: 1282-121 Authors: Shuaib Abdullah, Jeffrey Hastings, Suwetha Amsavelu, Francisco Garcia-Morales, Fury Hendrix, Aris Karatasakis, Barbara Danek, Judit Karacsonyi, Bavana Rangan, Michele Roesle, Houman Khalili, Subhash Banerjee, Emmanouil Brilakis, VA North Texas Medical Center, Dallas, TX, USA, University of Texas Southwestern Medical Center, Dallas, TX, USA Background: Although coronary chronic total occlusions (CTOs) are treated with percutaneous coronary intervention (PCI) to improve symptoms, studies demonstrating improvement in objective measures, such as peak oxygen uptake (V̇O2), are limited.
Methods: Patients referred for CTO PCI were prospectively enrolled. The primary outcome was improvement in peak V̇O2 during cardiopulmonary exercise (CPX) testing 5 months after CTO PCI. Secondary outcomes included improvement in physical capacity and angina, as assessed by questionnaires, and in plasma brain natriuretic peptide (BNP) levels.
Results: CTO PCI was attempted in 32 men (mean age 62; CTO vessel: 47% RCA; 44% LAD). In 1 patient CTO PCI was unsuccessful, and 3 patients had restenosis of their CTO vessel at follow-up. In the 28 patients with patent CTO vessel at follow-up, significant improvements were noted in self-reported physical capacity and angina. In the 27 patients who underwent baseline and follow-up CPX testing, peak V̇O2 significantly improved from 17.7 ± 4.3 ml/kg/min to 19.1 ± 4.0 ml/kg/min (p=0.02) among the 25 patients with patent CTO vessel, while in the 2 patients with restenosis, peak V̇O2 decreased (Figure). Plasma BNP levels significantly decreased from 143 ± 138 pg/ ml to 102 ± 123 pg/ml (p=0.01). Conclusions: CTO PCI in symptomatic patients was associated with improvements in cardiovascular exercise capacity, as assessed by peak V̇O2. These results suggest that in symptomatic patients with CTOs, PCI appears clinically beneficial.