Impact of chronic total occlusion lesion length on six-month angiographic and 2-year clinical outcomes

Jihun Ahn, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Kareem Abdelshafi, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Jin Su Byeon, Sang Ho ParkHye Yon Yu

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Abstract

Background Successful management of chronic total occlusion (CTO)by percutaneous coronary intervention (PCI) is known to be associated with better clinical outcomes than failed PCI. However, whether angiographic and clinical outcomes following PCI for long CTO lesions differ from those following PCI for short CTO lesions in the drug eluting stent (DES) era remains unknown. We therefore investigated whether CTO lesion length can significantly influence6-month angiographic and 2-year clinical outcomes following successful CTO PCI. Methods and results A total of 235 consecutive patients who underwent successful CTO intervention were allocated into either the long or short CTO group according to CTO lesion length. Six-month angiographic and 2-year clinical outcomes were then compared between the 2groups. We found that baseline clinical characteristics were generally similar between the 2 groups. Exceptions were prior PCI, which was more frequent in the long CTO group, and bifurcation lesions, which were more frequent in the short CTO group. Apart from intimal dissection, which was more frequent in the long than short CTO group, in-hospital complications were also similarly frequent between the 2groups. Furthermore, both groups had similar angiographic outcomes at 6 months and clinical outcomes at 2 years. However, the incidence of repeat PCI(predominantly target vessel revascularization),was higher in the long than short CTO group, with our multivariate analysis identifying long CTO as an important predictor of repeat PCI (odds ratio, 4.26;95% confidence interval, 1.53-11.9; p = 0.006). Conclusion The safety profile, 6-month angiographic, and 2-year clinical outcomes of CTO PCI were similar between patients with long and short CTO. However, there was a higher incidence of repeat PCI in long CTO patients despite successful PCI with DESs.

Original languageEnglish
Article numbere0198571
JournalPLoS One
Volume13
Issue number11
DOIs
Publication statusPublished - 2018 Nov 1

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Dissection
Stents
Percutaneous Coronary Intervention
Pharmaceutical Preparations
incidence
odds ratio
multivariate analysis
confidence interval
drugs
Multivariate Analysis
Tunica Intima
Drug-Eluting Stents
Incidence
methodology
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Impact of chronic total occlusion lesion length on six-month angiographic and 2-year clinical outcomes. / Ahn, Jihun; Rha, Seung-Woon; Choi, Byoung Geol; Choi, Se Yeon; Byun, Jae Kyeong; Mashaly, Ahmed; Abdelshafi, Kareem; Park, Yoonjee; Jang, Won Young; Kim, Woohyeun; Choi, Jah Yeon; Park, Eun Jin; Na, Jin Oh; Choi, Cheol Ung; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo; Byeon, Jin Su; Park, Sang Ho; Yu, Hye Yon.

In: PLoS One, Vol. 13, No. 11, e0198571, 01.11.2018.

Research output: Contribution to journalArticle

Ahn, J, Rha, S-W, Choi, BG, Choi, SY, Byun, JK, Mashaly, A, Abdelshafi, K, Park, Y, Jang, WY, Kim, W, Choi, JY, Park, EJ, Na, JO, Choi, CU, Kim, EJ, Park, CG, Seo, HS, Oh, DJ, Byeon, JS, Park, SH & Yu, HY 2018, 'Impact of chronic total occlusion lesion length on six-month angiographic and 2-year clinical outcomes', PLoS One, vol. 13, no. 11, e0198571. https://doi.org/10.1371/journal.pone.0198571
Ahn, Jihun ; Rha, Seung-Woon ; Choi, Byoung Geol ; Choi, Se Yeon ; Byun, Jae Kyeong ; Mashaly, Ahmed ; Abdelshafi, Kareem ; Park, Yoonjee ; Jang, Won Young ; Kim, Woohyeun ; Choi, Jah Yeon ; Park, Eun Jin ; Na, Jin Oh ; Choi, Cheol Ung ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Oh, Dong Joo ; Byeon, Jin Su ; Park, Sang Ho ; Yu, Hye Yon. / Impact of chronic total occlusion lesion length on six-month angiographic and 2-year clinical outcomes. In: PLoS One. 2018 ; Vol. 13, No. 11.
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abstract = "Background Successful management of chronic total occlusion (CTO)by percutaneous coronary intervention (PCI) is known to be associated with better clinical outcomes than failed PCI. However, whether angiographic and clinical outcomes following PCI for long CTO lesions differ from those following PCI for short CTO lesions in the drug eluting stent (DES) era remains unknown. We therefore investigated whether CTO lesion length can significantly influence6-month angiographic and 2-year clinical outcomes following successful CTO PCI. Methods and results A total of 235 consecutive patients who underwent successful CTO intervention were allocated into either the long or short CTO group according to CTO lesion length. Six-month angiographic and 2-year clinical outcomes were then compared between the 2groups. We found that baseline clinical characteristics were generally similar between the 2 groups. Exceptions were prior PCI, which was more frequent in the long CTO group, and bifurcation lesions, which were more frequent in the short CTO group. Apart from intimal dissection, which was more frequent in the long than short CTO group, in-hospital complications were also similarly frequent between the 2groups. Furthermore, both groups had similar angiographic outcomes at 6 months and clinical outcomes at 2 years. However, the incidence of repeat PCI(predominantly target vessel revascularization),was higher in the long than short CTO group, with our multivariate analysis identifying long CTO as an important predictor of repeat PCI (odds ratio, 4.26;95{\%} confidence interval, 1.53-11.9; p = 0.006). Conclusion The safety profile, 6-month angiographic, and 2-year clinical outcomes of CTO PCI were similar between patients with long and short CTO. However, there was a higher incidence of repeat PCI in long CTO patients despite successful PCI with DESs.",
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T1 - Impact of chronic total occlusion lesion length on six-month angiographic and 2-year clinical outcomes

AU - Ahn, Jihun

AU - Rha, Seung-Woon

AU - Choi, Byoung Geol

AU - Choi, Se Yeon

AU - Byun, Jae Kyeong

AU - Mashaly, Ahmed

AU - Abdelshafi, Kareem

AU - Park, Yoonjee

AU - Jang, Won Young

AU - Kim, Woohyeun

AU - Choi, Jah Yeon

AU - Park, Eun Jin

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Kim, Eung Ju

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Byeon, Jin Su

AU - Park, Sang Ho

AU - Yu, Hye Yon

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background Successful management of chronic total occlusion (CTO)by percutaneous coronary intervention (PCI) is known to be associated with better clinical outcomes than failed PCI. However, whether angiographic and clinical outcomes following PCI for long CTO lesions differ from those following PCI for short CTO lesions in the drug eluting stent (DES) era remains unknown. We therefore investigated whether CTO lesion length can significantly influence6-month angiographic and 2-year clinical outcomes following successful CTO PCI. Methods and results A total of 235 consecutive patients who underwent successful CTO intervention were allocated into either the long or short CTO group according to CTO lesion length. Six-month angiographic and 2-year clinical outcomes were then compared between the 2groups. We found that baseline clinical characteristics were generally similar between the 2 groups. Exceptions were prior PCI, which was more frequent in the long CTO group, and bifurcation lesions, which were more frequent in the short CTO group. Apart from intimal dissection, which was more frequent in the long than short CTO group, in-hospital complications were also similarly frequent between the 2groups. Furthermore, both groups had similar angiographic outcomes at 6 months and clinical outcomes at 2 years. However, the incidence of repeat PCI(predominantly target vessel revascularization),was higher in the long than short CTO group, with our multivariate analysis identifying long CTO as an important predictor of repeat PCI (odds ratio, 4.26;95% confidence interval, 1.53-11.9; p = 0.006). Conclusion The safety profile, 6-month angiographic, and 2-year clinical outcomes of CTO PCI were similar between patients with long and short CTO. However, there was a higher incidence of repeat PCI in long CTO patients despite successful PCI with DESs.

AB - Background Successful management of chronic total occlusion (CTO)by percutaneous coronary intervention (PCI) is known to be associated with better clinical outcomes than failed PCI. However, whether angiographic and clinical outcomes following PCI for long CTO lesions differ from those following PCI for short CTO lesions in the drug eluting stent (DES) era remains unknown. We therefore investigated whether CTO lesion length can significantly influence6-month angiographic and 2-year clinical outcomes following successful CTO PCI. Methods and results A total of 235 consecutive patients who underwent successful CTO intervention were allocated into either the long or short CTO group according to CTO lesion length. Six-month angiographic and 2-year clinical outcomes were then compared between the 2groups. We found that baseline clinical characteristics were generally similar between the 2 groups. Exceptions were prior PCI, which was more frequent in the long CTO group, and bifurcation lesions, which were more frequent in the short CTO group. Apart from intimal dissection, which was more frequent in the long than short CTO group, in-hospital complications were also similarly frequent between the 2groups. Furthermore, both groups had similar angiographic outcomes at 6 months and clinical outcomes at 2 years. However, the incidence of repeat PCI(predominantly target vessel revascularization),was higher in the long than short CTO group, with our multivariate analysis identifying long CTO as an important predictor of repeat PCI (odds ratio, 4.26;95% confidence interval, 1.53-11.9; p = 0.006). Conclusion The safety profile, 6-month angiographic, and 2-year clinical outcomes of CTO PCI were similar between patients with long and short CTO. However, there was a higher incidence of repeat PCI in long CTO patients despite successful PCI with DESs.

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