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Intermediate procedural and health status outcomes and the clinical care pathways after chronic total occlusion angioplasty: A report from the OPEN-CTO (outcomes, patient health status, and efficiency in chronic total occlusion hybrid procedures) study.
Sapontis, James; Hirai, Taishi; Patterson, Christian; Gans, Benjamin; Yeh, Robert W; Lombardi, William; Karmpaliotis, Dimitri; Moses, Jeffrey; Nicholson, William J; Pershad, Ashish; Wyman, R Michael; Spaedy, Anthony; Cook, Stephen; Doshi, Parag; Federici, Robert; Thompson, Craig A; Nugent, Karen; Gosch, Kensey; Grantham, J Aaron; Salisbury, Adam C.
Afiliação
  • Sapontis J; Monash Heart, Monash University, Melbourne, Australia.
  • Hirai T; Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.
  • Patterson C; University of Missouri-Kansas City, Kansas City, Missouri, USA.
  • Gans B; University of Missouri, Columbia, Missouri, USA.
  • Yeh RW; Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.
  • Lombardi W; Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.
  • Karmpaliotis D; University of Missouri-Kansas City, Kansas City, Missouri, USA.
  • Moses J; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
  • Nicholson WJ; University of Washington, Seattle, Washington, USA.
  • Pershad A; Columbia University, New York Presbyterian Hospital, New York, New York, USA.
  • Wyman RM; Columbia University, New York Presbyterian Hospital, New York, New York, USA.
  • Spaedy A; Emory University, Atlanta, Georgia, USA.
  • Cook S; Banner Good Samaritan Medical Center, Phoenix, AZ and Banner Heart, Mesa, Arizona, USA.
  • Doshi P; Torrance Medical Center, Torrance, California, USA.
  • Federici R; Boone County Hospital, Columbia, Missouri, USA.
  • Thompson CA; Peacehealth Sacred Heart Medical Center, Springfield, Oregon, USA.
  • Nugent K; Alexian Brothers Medical Center, Chicago, Illinois, USA.
  • Gosch K; Presbyterian Medical Group, Albuquerque, New Mexico, USA.
  • Grantham JA; New York University, New York, New York, USA.
  • Salisbury AC; Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.
Catheter Cardiovasc Interv ; 98(4): 626-635, 2021 10.
Article em En | MEDLINE | ID: mdl-33108056
ABSTRACT

BACKGROUND:

No previous reports have described the comprehensive care pathways involved in chronic total occlusion percutaneous coronary intervention (CTO PCI).

METHODS:

In a study of 1,000 consecutive patients undergoing CTO PCI using hybrid approach, a systematic algorithm of selecting CTO PCI strategies, the procedural characteristics, complication rates, and patient reported health status outcomes through 12 months were assessed.

RESULTS:

Technical success of the index CTO PCI was 86%, with 89% of patients having at least one successful CTO PCI within 12 months. A total of 13.8% underwent CTO PCI of another vessel or reattempt of index CTO PCI within 1 year. At 1 year, the unadjusted major adverse cardiac and cerebral event (MACCE) rate was lower in patients with successful index CTO PCI compared to patients with unsuccessful index CTO PCI (9.4% vs. 14.6%, p = .04). The adjusted hazard ratios of myocardial infarction and death at 12 months were numerically lower in patients with successful index CTO PCI, compared to patients with unsuccessful index CTO PCI. Patients with successful index CTO PCI reported significantly greater improvement in health status throughout 12-months compared to patients with unsuccessful index CTO PCI.

CONCLUSION:

CTO-PCI in the real-world often require treatment of second CTO, non-CTO PCI or repeat procedures to treat initially unsuccessful lesions. Successful CTO PCI is associated with numerically lower MACCE at 1 year and persistent symptomatic improvement compared to unsuccessful CTO PCI. Understanding the relationship between the care pathways following CTO PCI and health status benefit requires further study.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oclusão Coronária / Intervenção Coronária Percutânea Tipo de estudo: Etiology_studies / Guideline / Risk_factors_studies Limite: Humans Idioma: En Revista: Catheter Cardiovasc Interv Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oclusão Coronária / Intervenção Coronária Percutânea Tipo de estudo: Etiology_studies / Guideline / Risk_factors_studies Limite: Humans Idioma: En Revista: Catheter Cardiovasc Interv Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Austrália