TCT-417 Outcomes of Successful Versus Failed Contemporary Chronic Total Occlusion Percutaneous Coronary Intervention
Megaly M, Khalil M, Basir M, McEntegart M, Spratt J, Xu B, Alaswad K, and Brilakis E. TCT-417 Outcomes of Successful Versus Failed Contemporary Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2021; 78(19):B170-B171.
J Am Coll Cardiol
Background: There are limited contemporary data on the impact of success versus failure on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We conducted a systematic review and a meta-analysis of contemporary studies that compared the outcomes in patients who underwent successful versus failed contemporary (2010 onward) CTO PCI. We performed a sensitivity analysis limited to studies that started enrollment after the publication of the hybrid algorithm in 2012.
Results: We included 5 studies with a total of 6,084 patients (successful CTO PCI, n = 4,861; failed CTO PCI, n = 1,223). During a median follow-up period of 12 months (range: 6-60 months), successful CTO PCI was associated with a lower risk for major adverse cardiovascular events (MACE) (odds ratio [OR]: 0.61; 95% confidence interval [CI]: 0.41-0.92; P = 0.02; I2 = 63%) and all-cause death (OR: 0.57; 95% CI 0.33-0.99; P = 0.05; I2 = 60%). Both groups had similar risk for myocardial infarction (OR: 0.69; 95% CI 0.43-1.10; P = 0.38; I2 = 80%), target vessel revascularization (OR: 0.56; 95% CI 0.25-1.27; P = 0.17; I2 = 80%), and stroke (OR: 0.52; 95% CI 0.14-1.91; P = 0.33; I2 = 0%).
Conclusion: In contemporary practice, successful CTO PCI was associated with a lower incidence of MACE driven by lower all-cause mortality compared with failed CTO PCI at a median follow-up of 1 year. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)