Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents

Yangsoo Jang, Gwang Sil Kim, Byeong Keuk Kim, Dong Ho Shin, Jung Sun Kim, Myeong Ki Hong, Hyeon Cheol Gwon, Hyo Soo Kim, Cheol Woong Yu, Hun Sik Park, In Ho Chae, Seung Woon Rha

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Abstract

Background The aim of this study was to identify the prognostic predictors for the worse clinical outcomes after a successful chronic total occlusion (CTO) intervention with drug-eluting stents. Patients and results A total of 2334 patients in the multicenter Korean CTO registry who underwent a successful CTO intervention with drug-eluting stents (first generation, 1367, new generation, 967) were enrolled. The primary endpoint was the composite of cardiac death, myocardial infarction, and stent thrombosis. The cumulative incidence of the primary endpoint was 2.5% (median follow-up duration: 22 months). In multivariate analysis, age above 65 years [hazard ratio (HR)=1.769, 95% confidence interval (CI)=1.025-3.052, P=0.041], heart failure (HR=4.242, 95% CI=2.335-7.705, P<0.001), and diabetes (HR=1.773, 95% CI=1.043-3.012, P=0.034) were the significant predictors. The cumulative incidence of the primary endpoint was significantly higher in patients with three risk factors (19.1%) than in those with one (2.2%) or two (3.0%) risk factors (P=0.001). The cumulative target-vessel revascularization rate was 8.4%, with the significant predictors being a diffuse long lesion (HR=1.626, 95% CI=1.129-2.340, P=0.009) and at least three implanted stents (HR=1.964, 95% CI=1.301-2.965, P=0.001). Conclusion Clinical parameters such as age, diabetes, and heart failure were independent predictors of the composite of cardiac death, myocardial infarction, and stent thrombosis, whereas angiographic or procedural parameters such as lesion length and number of implanted stents were predictors of target-vessel revascularization. Clinical outcomes after CTO intervention were worse in patients with multiple risk factors.

Original languageEnglish
Pages (from-to)381-386
Number of pages6
JournalCoronary artery disease
Volume28
Issue number5
DOIs
Publication statusPublished - 2017 Jan 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Jang, Y., Kim, G. S., Kim, B. K., Shin, D. H., Kim, J. S., Hong, M. K., Gwon, H. C., Kim, H. S., Yu, C. W., Park, H. S., Chae, I. H., & Rha, S. W. (2017). Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents. Coronary artery disease, 28(5), 381-386. https://doi.org/10.1097/MCA.0000000000000498