Effect of complete percutaneous revascularization on improving long-term outcomes of patients with chronic total occlusion and multi-vessel disease.
10.1097/CM9.0000000000002653
- Author:
Zeya LI
1
;
Ziru ZHOU
2
;
Lei GUO
2
;
Lei ZHONG
2
;
Jingnan XIAO
2
;
Shaoke MENG
2
;
Yingdong WANG
2
;
Huaiyu DING
2
;
Bo ZHANG
2
;
Hao ZHU
2
;
Xuchen ZHOU
2
;
Rongchong HUANG
1
Author Information
1. Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Xuan Wu District, Beijing 100050, China.
2. Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Treatment Outcome;
Percutaneous Coronary Intervention/methods*;
Coronary Occlusion/surgery*;
Prognosis;
Angina, Unstable/surgery*;
Chronic Disease;
Risk Factors
- From:
Chinese Medical Journal
2023;136(8):959-966
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Limited data are available on the comparison of clinical outcomes of complete vs. incomplete percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) and multi-vessel disease (MVD). The study aimed to compare their clinical outcomes.
METHODS:A total of 558 patients with CTO and MVD were divided into the optimal medical treatment (OMT) group ( n = 86), incomplete PCI group ( n = 327), and complete PCI group ( n = 145). Propensity score matching (PSM) was performed between the complete and incomplete PCI groups as sensitivity analysis. The primary outcome was defined as the occurrence of major adverse cardiovascular events (MACEs), and unstable angina was defined as the secondary outcome.
RESULTS:At a median follow-up of 21 months, there were statistical differences among the OMT, incomplete PCI, and complete PCI groups in the rates of MACEs (43.0% [37/86] vs. 30.6% [100/327] vs. 20.0% [29/145], respectively, P = 0.016) and unstable angina (24.4% [21/86] vs. 19.3% [63/327] vs. 10.3% [15/145], respectively, P = 0.010). Complete PCI was associated with lower MACE compared with OMT (adjusted hazard ratio [HR] = 2.00; 95% confidence interval [CI] = 1.23-3.27; P = 0.005) or incomplete PCI (adjusted HR = 1.58; 95% CI = 1.04-2.39; P = 0.031). Sensitivity analysis of PSM showed similar results to the above on the rates of MACEs between complete PCI and incomplete PCI groups (20.5% [25/122] vs. 32.6% [62/190], respectively; adjusted HR = 0.55; 95% CI = 0.32-0.96; P = 0.035) and unstable angina (10.7% [13/122] vs. 20.5% [39/190], respectively; adjusted HR = 0.48; 95% CI = 0.24-0.99; P = 0.046).
CONCLUSIONS:For treatment of CTO and MVD, complete PCI reduced the long-term risk of MACEs and unstable angina, as compared with incomplete PCI and OMT. Complete PCI in both CTO and non-CTO lesions can potentially improve the prognosis of patients with CTO and MVD.
