Thirty‐day and 5‐year results of percutaneous coronary intervention for in‐stent restenotic chronic total occlusion lesions: Data from 2, 659 consecutive patients. (5th March 2021)

• Record Type: Journal Article
• Authors: Wang, Tianjie; Guan, Hao; Tian, Tao; Guan, Changdong; Bai, Yinxiao; Hu, Yang; Yuan, Jiansong; Qiao, Shubin; Xu, Bo; Yang, Weixian
• Other Names: Gao Runlin guestEditor.; Xu Bo guestEditor.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 97(2021)Supplement 2
• Page Start: 1016
• Page End: 1024
• Publication Date: 2021-03-05
• Subjects: coronary artery disease -- follow‐up study -- myocardial infarction; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.29585
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: To investigate the procedure success rate and clinical outcomes of in‐stent restenotic chronic total occlusion (ISR‐CTO) percutaneous coronary intervention (PCI). Background: Few studies have reported the short‐ and long‐term clinical outcomes of ISR‐CTO PCI. Method: Patients who underwent ISR‐CTO (n = 212) or de‐novo CTO (n = 2, 447) PCI at Fuwai Hospital from 2010 to 2013 were enrolled. Thirty‐day and 5‐year clinical outcomes were analyzed. The primary outcome was the incidence of all‐cause death, myocardial infarction (MI), and heart failure at follow‐up. The secondary outcome was the recanalization result (reasonable, suboptimal, or failed recanalization). Results: ISR‐CTO PCI had a higher rate of suboptimal recanalization than de‐novo CTO PCI ( p < .01). The syntax score before PCI (odds ratio (OR): 1.06; 95% confidence interval (CI): 1.02–1.10; p = .002) and occlusion length ≥ 20 mm (OR: 2.70:95% CI: 1.46–4.98; p = .001) were predictors of suboptimal recanalization in ISR‐CTO PCI. Cardiac death ( p = .03) and 30‐day all‐cause mortality ( p = .05) were higher among patients who underwent ISR‐CTO PCI. The ISR‐CTO group had a higher rate of MI ( p = .07) at 5 years. Suboptimal recanalization (hazard ratio: 2.56; 95% CI: 1.13–5.83; p = .025) was an independent predictor of long‐term major adverse events in ISR‐CTO. Conclusions: Suboptimal recanalization, 30‐day cardiac death, and long‐term MI rates are higher for ISR‐CTO PCI than de‐novo CTO PCI. Suboptimal recanalization is an independent predictor of long‐term major adverse events after ISR‐CTO PCI.