Predictors Associated with Major Adverse Cardiac Events Following Successful Chronic Total Occlusion Intervention with Drug-eluting Stents

Predictors Associated with Major Adverse Cardiac Events Following Successful Chronic Total Occlusion Intervention with Drug-eluting Stents

APRIL 23e26, 2013 - AS-143 Background: There is limited evidence regarding predictors associated with clinical outcomes of patients with chronic tot...

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APRIL 23e26, 2013

- AS-143

Background: There is limited evidence regarding predictors associated with clinical outcomes of patients with chronic total occlusion (CTO) successfully treated with drug-eluting stents (DESs). Methods: We investigated the 249 patients (pts) with de novo CTO lesions successfully treated with DESs from 2004 to 2010. All major adverse cardiovascular events (ALL-MACEs) were defined as composite of total death, any myocardial infarction (MI), target vessel revascularization (TVR) and non-target vessel revascularization. The association of ALL-MACEs with clinical, biochemical and procedural variables were examined. Results: The 12-month follow-up has been performed in the 242 of 249 pts (97.2%). The incidence of ALL-MACEs was the 40 of 242 patients (16.5%). Multivariate logistic regression was used to identify predictors affecting 1-year ALL-MACE. Left main involvement was significantly associated with 1-year ALL-MACEs and prior PCI history had a trend to be associated with 1-year ALL-MACEs (Table). Conclusion: In our study, left main involvement was an important independent predictor associated with 1-year MACE following successful CTO intervention with DES.

Coronary Computed Tomography Angiography Guided Triage of Patients with Suspected Coronary Artery Disease. Xue Zhai, Luyue Gai, Jingjing Gai, Kaiyi Zhang. Chinese PLA General Hospital, Beijing, China.

Table Predictors associated with 1-year ALL MACEs following CTO intervention

Chronic Total Occlusions Wednesday, April 24, 2013 2:00 PM w 6:00 PM (Abstract nos. AS-143, AS-144, AS-145, AS-146, AS-147, AS-148, AS-149, AS-150)

Variables Background: Coronary computed tomography angiography (CCTA) has been approved accurate for diagnosing coronary artery disease (CAD). However, its ability in correctly triaging patients to coronary intervention versus CAG in Chinese population remained unknown. Methods: The patients who underwent CCTA before coronary angiography (CAG) from Jan. 2008 to Feb. 2010 were included. The patients who underwent de novo CAG were served as the control. The percentage of percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), medical therapy and normal CAG were compared between the 2 groups. Results: In the control group, CAG was performed in 622 pts (179 female and 443 male), which resulted in 353 (56.75%) cases of PCI, 18 (2.89%) cases of CABG, 138 (22.19%) cases of medication and 113 (18.17%) cases of normal CAG. In the CCTA group, 132 cases (38 female and 94 male) were performed, which led to 81 (61.36%) cases of PCI, 9 (6.82%) cases of CABG, 31 (23.48%) cases of medication and 11 (8.33%) cases of normal CAG. In comparison with control, CCTA resulted in fewer normal CAG and more CABG (p<0.05).

Management

OCTA-CAG

PCI CABG Medication Normal

81 9 31 11

(61.36%) (6.82%) (23.48%) (8.33 %)

CAG 353 18 138 113

(56.75%) (2.89%) (22.19%) (18.17%)

p value 0.33 0.03 0.75 0.006

Conclusion: CCTA has significantly improved the patients triage by avoiding unnecessary CAG and referring more to CABG.

- AS-144 Predictors Associated with Major Adverse Cardiac Events Following Successful Chronic Total Occlusion Intervention with Drug-eluting Stents. Sang-Ho Park1, Seung-Woon Rha2, Ung Jun1, Se-Whan Lee1, Won-Yong Shin1, Seung-Jin Lee1, Dong-Kyu Jin1, Byoung Geol Choi2, Se Yeon Choi2, Sung Il Im2, Sun Won Kim2, Jin Oh Na2, Cheol Ung Choi2, Hong Euy Lim2, Jin Won Kim2, Eung Ju Kim2, Chang Gyu Park2, Hong Seog Seo2, Dong Joo Oh2. 1 Soonchunhyang University Cheonan Hospital, Cheonan, Korea (Republic of); 2Korea University Guro Hospital, Seoul, Korea (Republic of).

Age, per 1-year Male Hypertension Diabetes mellitus Smoking Hyperlipidemia Acute Myocardial infarction Multi-vessel disease Left main involvement History of prior PCI Cilostazol Left ventricular ejection fraction<30% Hemoglobin level, per 1 g/L. Creatinine level, per 1 mg/dL LDL-cholesterol< 100 mg/dL Glycated hemoglobin < 7.0 % High sensivity-CRP,per 1 mg/dL Number of total stent implantation IVUS-guided PCI Adjuvant ballooning

P value

OR

95% CI

0.168 0.577 0.788 0.539 0.112 0.929 0.295 0.975 0.045 0.074 0.225 0.416

1.047 0.617 1.188 0.609 3.205 1.061 2.082 0.979 10.254 4.229 2.329 0.361

0.981-1.118 0.113-0365 0.339-4.166 0.125-2.962 0.763-13.469 0.292-3.855 0.527-8.220 0.261-3.675 1.055-99.688 0.863-20.594 0.595-9.123 0.031-4.201

0.506 0.158 0.338 0.641 0.696 0.436 0.597 0.378

0.884 2.234 1.928 1.463 0.997 0.835 1.544 1.717

0.614-1.271 0.732-6.822 0.504-7.375 0.297-7.214 0.983-1.011 0.530-1.315 0.309-7.725 0.516-5.720

- AS-145 Multivessel Chronic Total Occlusion Outcomes Can Be Different with Single Vessel Chronic Total Occlusion? Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Sung Il Im, Sun Won Kim, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh. Korea University Guro Hospital, Seoul, Korea (Republic of). Background: Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher recurrence. It is not clear whether the angiographic and clinical outcomes may different between patients (pts) with single vessel CTO (SV-CTO) and multi-vessel CTO (MV-CTO). Methods: A total of 238 consecutive pts underwent CTO intervention were divided according to the number of target CTO vessels

The American Journal of Cardiologyâ APRIL 23e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster

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