Five-Year Outcomes of Successful Percutaneous Coronary Intervention with Drug-Eluting Stents versus Medical Therapy for Chronic Total Occlusions.
10.3349/ymj.2018.59.5.602
- Author:
Seung Woon RHA
1
;
Byoung Geol CHOI
;
Man Jong BAEK
;
Yang gi RYU
;
Hu LI
;
Se Yeon CHOI
;
Jae Kyeong BYUN
;
Ahmed MASHALY
;
Yoonjee PARK
;
Won Young JANG
;
Woohyeun KIM
;
Jah Yeon CHOI
;
Eun Jin PARK
;
Jin Oh NA
;
Cheol Ung CHOI
;
Hong Euy LIM
;
Eung Ju KIM
;
Chang Gyu PARK
;
Hong Seog SEO
;
Dong Joo OH
Author Information
1. Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea. swrha617@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Chronic total occlusion;
percutaneous coronary intervention;
drug-eluting stent;
medical therapy
- MeSH:
Coronary Angiography;
Drug-Eluting Stents*;
Humans;
Incidence;
Logistic Models;
Myocardial Infarction;
Percutaneous Coronary Intervention*;
Propensity Score;
Stroke
- From:Yonsei Medical Journal
2018;59(5):602-610
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Many recent studies have reported that successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) for chronic total occlusion (CTO) has more beneficial effects than failed CTO-PCI; however, there are only limited data available from comparisons of successful CTO-PCI with medical therapy (MT) in the Korean population. MATERIALS AND METHODS: A total of 840 consecutive CTO patients who underwent diagnostic coronary angiography, receiving either PCI with DESs or MT, were enrolled. Patients were divided into two groups according to the treatment assigned. To adjust for potential confounders, propensity score matching (PSM) analysis was performed using logistic regression. Individual major clinical outcomes and major adverse cardiac events, a composite of total death, myocardial infarction (MI), stroke, and revascularization, were compared between the two groups up to 5 years. RESULTS: After PSM, two propensity-matched groups (265 pairs, n=530) were generated, and the baseline characteristics were balanced. Although the PCI group showed a higher incidence of target lesion and vessel revascularization on CTO, the incidence of MI tended to be lower [hazard ratio (HR): 0.339, 95% confidence interval (CI): 0.110 to 1.043, p=0.059] and the composite of total death or MI was lower (HR: 0.454, 95% CI: 0.224 to 0.919, p=0.028), compared with the MT group up to 5 years. CONCLUSION: In this study, successful CTO PCI with DESs was associated with a higher risk of repeat PCI for the target vessel, but showed a reduced incidence of death or MI.
