Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents

for the K-CTO Registry

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: The aim of this study was to identify the prognostic predictors for the worse clinical outcomes after a successful chronic total occlusion (CTO) intervention with drug-eluting stents. PATIENTS AND RESULTS: A total of 2334 patients in the multicenter Korean CTO registry who underwent a successful CTO intervention with drug-eluting stents (first generation, 1367, new generation, 967) were enrolled. The primary endpoint was the composite of cardiac death, myocardial infarction, and stent thrombosis.The cumulative incidence of the primary endpoint was 2.5% (median follow-up duration: 22 months). In multivariate analysis, age above 65 years [hazard ratio (HR)=1.769, 95% confidence interval (CI)=1.025–3.052, P=0.041], heart failure (HR=4.242, 95% CI=2.335–7.705, P<0.001), and diabetes (HR=1.773, 95% CI=1.043–3.012, P=0.034) were the significant predictors. The cumulative incidence of the primary endpoint was significantly higher in patients with three risk factors (19.1%) than in those with one (2.2%) or two (3.0%) risk factors (P=0.001). The cumulative target-vessel revascularization rate was 8.4%, with the significant predictors being a diffuse long lesion (HR=1.626, 95% CI=1.129–2.340, P=0.009) and at least three implanted stents (HR=1.964, 95% CI=1.301–2.965, P=0.001). CONCLUSION: Clinical parameters such as age, diabetes, and heart failure were independent predictors of the composite of cardiac death, myocardial infarction, and stent thrombosis, whereas angiographic or procedural parameters such as lesion length and number of implanted stents were predictors of target-vessel revascularization. Clinical outcomes after CTO intervention were worse in patients with multiple risk factors.

Original languageEnglish
JournalCoronary Artery Disease
DOIs
Publication statusAccepted/In press - 2017 May 24

Fingerprint

Drug-Eluting Stents
Stents
Confidence Intervals
Thrombosis
Heart Failure
Myocardial Infarction
Incidence
Registries
Multivariate Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents. / for the K-CTO Registry.

In: Coronary Artery Disease, 24.05.2017.

Research output: Contribution to journalArticle

@article{a810acb6f92c4711b64edcb8d9f192cc,
title = "Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents",
abstract = "BACKGROUND: The aim of this study was to identify the prognostic predictors for the worse clinical outcomes after a successful chronic total occlusion (CTO) intervention with drug-eluting stents. PATIENTS AND RESULTS: A total of 2334 patients in the multicenter Korean CTO registry who underwent a successful CTO intervention with drug-eluting stents (first generation, 1367, new generation, 967) were enrolled. The primary endpoint was the composite of cardiac death, myocardial infarction, and stent thrombosis.The cumulative incidence of the primary endpoint was 2.5{\%} (median follow-up duration: 22 months). In multivariate analysis, age above 65 years [hazard ratio (HR)=1.769, 95{\%} confidence interval (CI)=1.025–3.052, P=0.041], heart failure (HR=4.242, 95{\%} CI=2.335–7.705, P<0.001), and diabetes (HR=1.773, 95{\%} CI=1.043–3.012, P=0.034) were the significant predictors. The cumulative incidence of the primary endpoint was significantly higher in patients with three risk factors (19.1{\%}) than in those with one (2.2{\%}) or two (3.0{\%}) risk factors (P=0.001). The cumulative target-vessel revascularization rate was 8.4{\%}, with the significant predictors being a diffuse long lesion (HR=1.626, 95{\%} CI=1.129–2.340, P=0.009) and at least three implanted stents (HR=1.964, 95{\%} CI=1.301–2.965, P=0.001). CONCLUSION: Clinical parameters such as age, diabetes, and heart failure were independent predictors of the composite of cardiac death, myocardial infarction, and stent thrombosis, whereas angiographic or procedural parameters such as lesion length and number of implanted stents were predictors of target-vessel revascularization. Clinical outcomes after CTO intervention were worse in patients with multiple risk factors.",
author = "{for the K-CTO Registry} and Kim, {Gwang Sil} and Kim, {Byeong Keuk} and Shin, {Dong Ho} and Kim, {Jung Sun} and Hong, {Myeong Ki} and Gwon, {Hyeon Cheol} and Kim, {Hyo Soo} and Yu, {Cheol Woong} and Yu, {Cheol Woong} and Chae, {In Ho} and Rha, {Seung Woon} and Seung-Woon Rha",
year = "2017",
month = "5",
day = "24",
doi = "10.1097/MCA.0000000000000498",
language = "English",
journal = "Coronary Artery Disease",
issn = "0954-6928",
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T1 - Predictors of poor clinical outcomes after successful chronic total occlusion intervention with drug-eluting stents

AU - for the K-CTO Registry

AU - Kim, Gwang Sil

AU - Kim, Byeong Keuk

AU - Shin, Dong Ho

AU - Kim, Jung Sun

AU - Hong, Myeong Ki

AU - Gwon, Hyeon Cheol

AU - Kim, Hyo Soo

AU - Yu, Cheol Woong

AU - Yu, Cheol Woong

AU - Chae, In Ho

AU - Rha, Seung Woon

AU - Rha, Seung-Woon

PY - 2017/5/24

Y1 - 2017/5/24

N2 - BACKGROUND: The aim of this study was to identify the prognostic predictors for the worse clinical outcomes after a successful chronic total occlusion (CTO) intervention with drug-eluting stents. PATIENTS AND RESULTS: A total of 2334 patients in the multicenter Korean CTO registry who underwent a successful CTO intervention with drug-eluting stents (first generation, 1367, new generation, 967) were enrolled. The primary endpoint was the composite of cardiac death, myocardial infarction, and stent thrombosis.The cumulative incidence of the primary endpoint was 2.5% (median follow-up duration: 22 months). In multivariate analysis, age above 65 years [hazard ratio (HR)=1.769, 95% confidence interval (CI)=1.025–3.052, P=0.041], heart failure (HR=4.242, 95% CI=2.335–7.705, P<0.001), and diabetes (HR=1.773, 95% CI=1.043–3.012, P=0.034) were the significant predictors. The cumulative incidence of the primary endpoint was significantly higher in patients with three risk factors (19.1%) than in those with one (2.2%) or two (3.0%) risk factors (P=0.001). The cumulative target-vessel revascularization rate was 8.4%, with the significant predictors being a diffuse long lesion (HR=1.626, 95% CI=1.129–2.340, P=0.009) and at least three implanted stents (HR=1.964, 95% CI=1.301–2.965, P=0.001). CONCLUSION: Clinical parameters such as age, diabetes, and heart failure were independent predictors of the composite of cardiac death, myocardial infarction, and stent thrombosis, whereas angiographic or procedural parameters such as lesion length and number of implanted stents were predictors of target-vessel revascularization. Clinical outcomes after CTO intervention were worse in patients with multiple risk factors.

AB - BACKGROUND: The aim of this study was to identify the prognostic predictors for the worse clinical outcomes after a successful chronic total occlusion (CTO) intervention with drug-eluting stents. PATIENTS AND RESULTS: A total of 2334 patients in the multicenter Korean CTO registry who underwent a successful CTO intervention with drug-eluting stents (first generation, 1367, new generation, 967) were enrolled. The primary endpoint was the composite of cardiac death, myocardial infarction, and stent thrombosis.The cumulative incidence of the primary endpoint was 2.5% (median follow-up duration: 22 months). In multivariate analysis, age above 65 years [hazard ratio (HR)=1.769, 95% confidence interval (CI)=1.025–3.052, P=0.041], heart failure (HR=4.242, 95% CI=2.335–7.705, P<0.001), and diabetes (HR=1.773, 95% CI=1.043–3.012, P=0.034) were the significant predictors. The cumulative incidence of the primary endpoint was significantly higher in patients with three risk factors (19.1%) than in those with one (2.2%) or two (3.0%) risk factors (P=0.001). The cumulative target-vessel revascularization rate was 8.4%, with the significant predictors being a diffuse long lesion (HR=1.626, 95% CI=1.129–2.340, P=0.009) and at least three implanted stents (HR=1.964, 95% CI=1.301–2.965, P=0.001). CONCLUSION: Clinical parameters such as age, diabetes, and heart failure were independent predictors of the composite of cardiac death, myocardial infarction, and stent thrombosis, whereas angiographic or procedural parameters such as lesion length and number of implanted stents were predictors of target-vessel revascularization. Clinical outcomes after CTO intervention were worse in patients with multiple risk factors.

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