TCT-417 Outcomes of Successful Versus Failed Contemporary Chronic Total Occlusion Percutaneous Coronary Intervention

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Conference Proceeding

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Publication Title

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)





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