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

Research output: Contribution to journalArticle

2 Citations (Scopus)

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

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Drug-Eluting Stents
Stents
Confidence Intervals
Thrombosis
Heart Failure
Myocardial Infarction
Incidence
Registries
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Jang, Yangsoo ; Kim, Gwang Sil ; Kim, Byeong Keuk ; Shin, Dong Ho ; Kim, Jung Sun ; Hong, Myeong Ki ; Gwon, Hyeon Cheol ; Kim, Hyo Soo ; Yu, Cheol Woong ; Park, Hun Sik ; Chae, In Ho ; Rha, Seung Woon. / Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents. In: Coronary artery disease. 2017 ; Vol. 28, No. 5. pp. 381-386.
@article{748a3e7b1a4a47b8898054787bc70bf8,
title = "Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents",
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.",
author = "Yangsoo Jang and Kim, {Gwang Sil} and Kim, {Byeong Keuk} and Shin, {Dong Ho} and Kim, {Jung Sun} and Hong, {Myeong Ki} and Gwon, {Hyeon Cheol} and Kim, {Hyo Soo} and Yu, {Cheol Woong} and Park, {Hun Sik} and Chae, {In Ho} and Rha, {Seung Woon}",
year = "2017",
month = "1",
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doi = "10.1097/MCA.0000000000000498",
language = "English",
volume = "28",
pages = "381--386",
journal = "Coronary Artery Disease",
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}

Jang, Y, Kim, GS, Kim, BK, Shin, DH, Kim, JS, Hong, MK, Gwon, HC, Kim, HS, Yu, CW, Park, HS, Chae, IH & Rha, SW 2017, 'Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents', Coronary artery disease, vol. 28, no. 5, pp. 381-386. https://doi.org/10.1097/MCA.0000000000000498

Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents. / Jang, Yangsoo; Kim, Gwang Sil; Kim, Byeong Keuk; Shin, Dong Ho; Kim, Jung Sun; Hong, Myeong Ki; Gwon, Hyeon Cheol; Kim, Hyo Soo; Yu, Cheol Woong; Park, Hun Sik; Chae, In Ho; Rha, Seung Woon.

In: Coronary artery disease, Vol. 28, No. 5, 01.01.2017, p. 381-386.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents

AU - Jang, Yangsoo

AU - Kim, Gwang Sil

AU - Kim, Byeong Keuk

AU - Shin, Dong Ho

AU - Kim, Jung Sun

AU - Hong, Myeong Ki

AU - Gwon, Hyeon Cheol

AU - Kim, Hyo Soo

AU - Yu, Cheol Woong

AU - Park, Hun Sik

AU - Chae, In Ho

AU - Rha, Seung Woon

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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.

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U2 - 10.1097/MCA.0000000000000498

DO - 10.1097/MCA.0000000000000498

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AN - SCOPUS:85019669076

VL - 28

SP - 381

EP - 386

JO - Coronary Artery Disease

JF - Coronary Artery Disease

SN - 0954-6928

IS - 5

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