Long-term impact of chronic total occlusion recanalisation in patients with ST-elevation myocardial infarction

Heart
Joëlle EliasEXPLORE investigators

Abstract

During primary percutaneous coronary intervention (PCI), a concurrent chronic total occlusion (CTO) is found in 10% of patients with ST-elevation myocardial infarction (STEMI). Long-term benefits of CTO-PCI have been suggested; however, randomised data are lacking. Our aim was to determine mid-term and long-term clinical outcome of CTO-PCI versus CTO-No PCI in patients with STEMI with a concurrent CTO. The Evaluating Xience and left ventricular function in PCI on occlusiOns afteR STEMI (EXPLORE) was a multicentre randomised trial that included 302 patients with STEMI after successful primary PCI with a concurrent CTO. Patients were randomised to either CTO-PCI or CTO-No PCI. The primary end point of the current study was occurrence of major adverse cardiac events (MACE): cardiac death, coronary artery bypass grafting and MI. Other end points were 1-year left ventricular function (LVF); LV-ejection fraction and LV end-diastolic volume and angina status. The median long-term follow-up was 3.9 (2.1-5.0) years. MACE was not significantly different between both arms (13.5% vs 12.3%, HR 1.03, 95% CI 0.54 to 1.98; P=0.93). Cardiac death was more frequent in the CTO-PCI arm (6.0% vs 1.0%, P=0.02) with no difference in all-cause mortali...Continue Reading

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Citations

Apr 9, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Nicolas BoudouCarlo Di Mario
Apr 11, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Anna van VeelenJosé P S Henriques
Nov 30, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Michael MegalyEmmanouil S Brilakis
Apr 16, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Maarten Z H KolkJosé P S Henriques
Sep 6, 2018·Heart·Clerio Francisco de Azevedo, Márcio Sommer Bittencourt
Jul 1, 2020·Expert Review of Cardiovascular Therapy·Ilias NikolakopoulosEmmanouil S Brilakis
Dec 14, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Julinda Mehilli
Feb 19, 2020·Circulation. Cardiovascular Interventions·John A Bittl
Oct 17, 2020·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·A van VeelenJ P S Henriques
Feb 2, 2021·Chinese Medical Journal·Ming-Lian GongJing-Hua Liu
Jun 26, 2021·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Valeria ParadiesPieter Cornelis Smits
Jun 2, 2021·Current Cardiology Reviews·Mohamed Farag, Mohaned Egred
Dec 22, 2021·Circulation. Cardiovascular Interventions·Bradley H StraussHarindra C Wijeysundera

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