Meta-analysis of clinical outcomes of patients who underwent percutaneous coronary interventions for chronic total occlusions

The American Journal of Cardiology
Georgios E ChristakopoulosEmmanouil S Brilakis

Abstract

Successful percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) has been associated with clinical benefit. There are no randomized controlled trials on long-term clinical outcomes after CTO PCI, limiting the available evidence to observational cohort studies. We sought to perform a weighted meta-analysis of the long-term outcomes of successful versus failed CTO PCI. A total of 25 studies, published from 1990 to 2014, with 28,486 patients (29,315 CTO PCI procedures) were included. We analyzed data on mortality, subsequent coronary artery bypass grafting (CABG), myocardial infarction, major adverse cardiac events, angina pectoris, stroke, and target vessel revascularization using random-effects models. Procedural success was 71% (range 51% to 87%). During a weighted mean follow-up of 3.11 years, compared with unsuccessful, successful CTO PCI was associated with lower mortality (odds ratio [OR] 0.52, 95% confidence interval [CI] 0.43 to 0.63), less residual angina (OR 0.38, 95% CI 0.24 to 0.60), lower risk for stroke (OR 0.72, 95% CI 0.60 to 0.88), less need for subsequent coronary artery bypass grafting (OR 0.18, 95% CI 0.14 to 0.22), and lower risk for major adverse cardiac events (0.59, 95% CI 0.44 to 0....Continue Reading

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Citations

Sep 4, 2015·European Heart Journal·Yaron Arbel, Bradley H Strauss
Feb 3, 2016·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Emmanouil S Brilakis, Minh N Vo
Mar 24, 2016·The Canadian Journal of Cardiology·Suwetha AmsaveluEmmanouil S Brilakis
Apr 29, 2015·The American Journal of Cardiology·Georgios E ChristakopoulosEmmanouil S Brilakis
May 18, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Aris KaratasakisEmmanouil S Brilakis
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Aug 29, 2016·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Sina ValieeParvin Mahmoodi
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