Author + information
- Received February 21, 2017
- Revision received June 26, 2017
- Accepted June 29, 2017
- Published online November 6, 2017.
- Alfredo R. Galassi, MDa,b,∗ (, )
- Marouane Boukhris, MDa,c,
- Aurel Toma, MDd,
- Zied Ibn Elhadj, MDc,
- Lobna Laroussi, MDc,
- Oliver Gaemperli, MDb,
- Michael Behnes, MDe,
- Ibrahim Akin, MDe,
- Thomas F. Lüscher, MDb,
- Franz J. Neumann, MDd and
- Kambis Mashayekhi, MDd
- aDepartment of Experimental and Clinical Medicine, University of Catania, Catania, Italy
- bUniversity Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
- cCardiology Department, Abderrhamen Mami Hospital, Ariana, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- dDivision of Cardiology and Angiology II, University Heart Center Freiburg – Bad Krozingen, Bad Krozingen, Germany
- eFirst Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany
- ↵∗Address for correspondence:
Dr. Alfredo R. Galassi, Via Antonello da Messina 75, Acicastello, 95021 Catania, Italy.
Objectives The study sought to assess the outcome of percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) in patients with low left ventricular ejection fraction (LVEF) (≤35%).
Background Data regarding the outcome of PCI in patients with low LVEF affected by CTO are scarcely reported.
Methods The authors performed a prospective longitudinal multicenter study including consecutive patients undergoing elective PCI of CTOs. Patients were subdivided into 3 groups: group 1 (LVEF ≥50%), group 2 (LVEF 35% to 50%), and group 3 (LVEF ≤35%).
Results A total of 839 patients (mean 64.6 ± 10.5 years of age, 87.7% men) underwent CTO PCI attempts. Baseline LVEF ≤35% was present in 72 (8.6%) patients. The angiographic success was high (overall 93.6%) and similar among the 3 groups (93.5% vs. 94.4% vs. 91.7%, respectively; all p = NS). In group 3, no periprocedural complications of CTO PCI were observed. Mean clinical follow-up of 16.3 ± 8.2 months duration was available in 781 (93.1%) patients including those with LVEF ≤35%. At 2 years, major cardiac and cerebrovascular events (MACCE) free survival was similar in the 3 groups (86% vs. 82.8% vs. 75.2%; all p = NS). In patients with LVEF ≤35%, LVEF improved significantly in the presence of a successful CTO PCI from 29.1 ± 3.4% to 41.6 ± 7.9% (p < 0.001).
Conclusions In CTO patients with low LVEF, PCI could represent a safe and effective revascularization strategy achieving good midterm outcome and LVEF improvement.
Dr. Lüscher has received research and educational grants from AstraZeneca, Biotronik, Eli Lilly, Medtronic, Boston Scientific, Abbott, and St. Jude Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 21, 2017.
- Revision received June 26, 2017.
- Accepted June 29, 2017.
- 2017 American College of Cardiology Foundation