Author + information
- Received July 23, 2015
- Revision received November 12, 2015
- Accepted November 16, 2015
- Published online March 28, 2016.
- Pil Hyung Lee, MD,
- Seung-Whan Lee, MD, PhD,
- Hee-Soon Park, MD,
- Se Hun Kang, MD,
- Byeong Joo Bae, MD,
- Mineok Chang, MD,
- Jae-Hyung Roh, MD,
- Sung-Han Yoon, MD,
- Jung-Min Ahn, MD,
- Duk-Woo Park, MD, PhD,
- Soo-Jin Kang, MD, PhD,
- Young-Hak Kim, MD, PhD,
- Cheol Whan Lee, MD, PhD,
- Seong-Wook Park, MD, PhD and
- Seung-Jung Park, MD, PhD∗ ()
- Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- ↵∗Reprint requests and correspondence:
Dr. Seung-Jung Park, Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea.
Objectives The purpose of this study was to evaluate long-term clinical outcomes after drug-eluting stent–supported percutaneous coronary intervention (PCI) for native coronary total occlusion (CTO).
Background The benefit of successful recanalization of CTO on prognosis remains uncertain.
Methods Between March 2003 and May 2014, 1,173 consecutive patients with CTO of native coronary vessels requiring PCI were enrolled. Drug-eluting stent implantation was performed in all successful procedures (1,004 patients, 85.6%).
Results During a median follow-up of 4.6 years, the adjusted risks of all-cause mortality (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 0.53 to 2.04; p = 0.92) and the composite of death or myocardial infarction (HR: 1.05; 95% CI: 0.56 to 1.94; p = 0.89) were found to be comparable between patients with successful and failed CTO-PCI, whereas the adjusted risk of target vessel revascularization (HR: 0.15; 95% CI: 0.10 to 0.25; p < 0.001) and coronary artery bypass grafting (HR: 0.02; 95% CI: 0.006 to 0.06, p < 0.001) was significantly higher in patients with failed CTO-PCI. Among patients (n = 879) in whom complete revascularization for non-CTO vessels was performed, the risk of death or the composite of death or myocardial infarction were not found to differ between patients who underwent successful recanalization of the remaining CTO and patients who did not. This finding was consistent regardless of whether the patient had a multivessel disease including CTO or only had a single CTO disease.
Conclusions Successful CTO-PCI compared with failed PCI was not associated with a lesser risk for mortality. However, successful CTO-PCI was associated with significantly less subsequent coronary artery bypass grafting.
This study was supported by a grant from the Ministry of Food and Drug Safety (15172MFDS431) and the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI14C0517). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. The first 2 authors contributed equally to this article
- Received July 23, 2015.
- Revision received November 12, 2015.
- Accepted November 16, 2015.
- American College of Cardiology Foundation