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

Authors
 Kim Gwang-Sil  ;  Kim Byeong-Keuk  ;  Shin Dong-Ho  ;  Kim Jung-Sun  ;  Hong Myeong-Ki  ;  Gwon Hyeon-Cheol  ;  Kim Hyo-Soo  ;  Yu Cheol Woong  ;  Park Hun Sik  ;  Chae In-Ho  ;  Rha Seung-Woon  ;  Jang Yangsoo  ;  K-CTO Registry 
Citation
 CORONARY ARTERY DISEASE, Vol.28(5) : 381-386, 2017 
Journal Title
 CORONARY ARTERY DISEASE 
ISSN
 0954-6928 
Issue Date
2017
MeSH
Age Factors ; Aged ; Chi-Square Distribution ; Chronic Disease ; Comorbidity ; Coronary Angiography ; Coronary Occlusion/diagnostic imaging ; Coronary Occlusion/mortality ; Coronary Occlusion/therapy* ; Coronary Thrombosis/etiology ; Coronary Thrombosis/mortality ; Drug-Eluting Stents* ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/etiology ; Myocardial Infarction/mortality ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/instrumentation* ; Percutaneous Coronary Intervention/mortality ; Proportional Hazards Models ; Registries ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome
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.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00019501-201708000-00006&LSLINK=80&D=ovft
DOI
10.1097/MCA.0000000000000498
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gwang Sil(김광실)
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160395
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