A comparison of procedural success rate and long-term clinical outcomes between in-stent restenosis chronic total occlusion and de novo chronic total occlusion using multicenter registry data
- Authors
- Lee, Seung Hun; Cho, Jae Young; Kim, Je Sang; Lee, Hyun Jong; Yang, Jeong Hoon; Park, Jae Hyoung; Hong, Soon Jun; Choi, Rak Kyeong; Choi, Seung-Hyuk; Gwon, Hyeon-Cheol; Lim, Do-Sun; Yu, Cheol Woong
- Issue Date
- 5월-2020
- Publisher
- SPRINGER HEIDELBERG
- Keywords
- Chronic coronary total occlusion; In-stent restenosis; Percutaneous coronary interventions
- Citation
- CLINICAL RESEARCH IN CARDIOLOGY, v.109, no.5, pp.628 - 637
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL RESEARCH IN CARDIOLOGY
- Volume
- 109
- Number
- 5
- Start Page
- 628
- End Page
- 637
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/56111
- DOI
- 10.1007/s00392-019-01550-7
- ISSN
- 1861-0684
- Abstract
- Background There have been little data about outcomes of percutaneous coronary intervention (PCI) for in-stent restenosis (ISR) chronic total occlusion (CTO) in the drug eluting stent (DES) era. This study aimed to compare the procedural success rate and long-term clinical outcomes of ISR CTO and de novo CTO. Methods and results Patients who underwent PCI for ISR CTO (n = 164) versus de novo CTO (n = 1208) were enrolled from three centers in Korea between January 2008 and December 2014. Among a total of ISR CTO, a proportion of DES ISR CTO was 79.3% (n = 130). The primary outcome was major adverse cardiac events (MACEs); a composite of all-cause death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR). Following propensity score-matching (1:3), the ISR CTO group (n = 156) had a higher success rate (84.6% vs. 76.0%, p = 0.035), mainly driven by high success rate of PCI for DES ISR CTO (88.6%), but showed a higher incidence of MACEs [hazard ratio (HR): 2.06; 95% confidence interval (CI) 1.37-3.09; p < 0.001], mainly driven by higher prevalence of MI [HR: 9.71; 95% CI 2.06-45.81; p = 0.004] and TLR [HR: 3.04; 95% CI 1.59-5.81; p = 0.001], during 5 years of follow-up after successful revascularization, as compared to the de novo CTO group (n = 408). Conclusion The procedural success rate was higher in the ISR CTO than the de novo CTO, especially in DES ISR CTO. However, irrespective of successful revascularization, the long-term clinical outcomes for the ISR CTO were significantly worse than those for the de novo CTO, in terms of MI and TLR. Graphic abstract
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Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
- College of Medicine > Department of Medical Science > 1. Journal Articles
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