Author + information
- Received March 28, 2016
- Revision received May 16, 2016
- Accepted June 2, 2016
- Published online September 12, 2016.
- Mateusz Tajstra, MD, PhDa,∗ (, )
- Łukasz Pyka, MDa,
- Jarosław Gorol, MDa,
- Damian Pres, MD, PhDa,
- Marek Gierlotka, MD, PhDa,
- Elżbieta Gadula-Gacek, MDa,
- Anna Kurek, MDa,
- Michał Wasiak, MDa,
- Michał Hawranek, MD, PhDa,
- Michał Oskar Zembala, MD, PhDb,
- Andrzej Lekston, MD, PhDa,
- Lech Poloński, MD, PhDa,
- Leszek Bryniarski, MD, PhDc and
- Mariusz Gąsior, MD, PhDa
- a3rd Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Silesian Centre for Heart Disease, Zabrze, Poland
- bDepartment of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland
- cFirst Department of Cardiology and Hypertension, Institute of Cardiology, Jagiellonian University, Medical College, Kraków, Poland
- ↵∗Reprint Requests and Correspondence:
Dr. Mateusz Tajstra, ul. Curie-Skłodowskiej 9, Zabrze 41-800, Poland.
Objectives This study sought to assess the impact of chronic total occlusion (CTO) on long-term prognosis in patients with ischemic cardiomyopathy.
Background The presence of concomitant CTO in a nonculprit lesion in acute coronary syndromes is associated with worse prognosis. Coronary artery disease is the main cause of heart failure and in many cases at least 1 CTO is observed.
Methods The study included all patients with systolic heart failure who underwent elective coronary angiography and were registered from January 2009 to December 2014 in the ongoing single-center COMMIT-HF (COnteMporary Modalities In Treatment of Heart Failure) registry (NCT02536443). The patients were divided into 2 groups with regard to CTO presence. All of the analyzed patients were followed up for at least 12 months with all-cause mortality defined as the primary endpoint.
Results Of the 675 patients fulfilling the inclusion and exclusion criteria, 278 patients (41.2%) had 1 or more CTOs of a major coronary artery (+CTO), and in 397 patients (58.8%) the presence of the CTO was not observed (−CTO). The 12-month mortality for the +CTO and −CTO patients was 19.4 % and 10.3 %, respectively (p < 0.001), evident also after 24 months (26.6% vs. 17.6%; p = 0.01). After a multivariate adjustment for differences in baseline characteristics, the presence of CTO remained significantly associated with higher 12-month mortality (relative risk: 1.84: 95% confidence interval: 1.18 to 2.85; p = 0.006).
Conclusions Our analysis showed that in patients with ischemic heart failure the presence of the CTO is related to worse long-term prognosis.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 28, 2016.
- Revision received May 16, 2016.
- Accepted June 2, 2016.
- 2016 American College of Cardiology Foundation