6533b821fe1ef96bd127b7b2

RESEARCH PRODUCT

Percutaneous coronary intervention of chronic total occlusions in patients with low left ventricular ejection fraction

Aurel TomaMarouane BoukhrisFranz J. NeumannOliver GaemperliThomas F. LüscherAlfredo R. GalassiMichael BehnesLobna LaroussiKambis MashayekhiZied Ibn ElhadjIbrahim Akin

subject

Malemedicine.medical_specialtyanimal structuresTime Factorsmedicine.medical_treatment610 Medicine & healthKaplan-Meier Estimate030204 cardiovascular system & hematologyCoronary AngiographyDisease-Free SurvivalVentricular Function Left2705 Cardiology and Cardiovascular Medicinechronic total occlusion; ischemic LV dysfunction; left ventricular ejection fraction; PCI; Cardiology and Cardiovascular Medicinechronic total occlusionischemic LV dysfunctionleft ventricular ejection fractionPCI03 medical and health sciences0302 clinical medicinePercutaneous Coronary InterventionRisk FactorsInternal medicinemedicineHumansIn patientcardiovascular diseases030212 general & internal medicineLongitudinal StudiesProspective Studieschronic total occlusionAgedProportional Hazards ModelsEjection fractionbusiness.industryPercutaneous coronary interventionleft ventricular ejection fractionPCIStroke VolumeRecovery of FunctionMiddle AgedSurgeryEuropeTreatment OutcomeCoronary OcclusionConventional PCIChronic DiseaseCardiology10209 Clinic for CardiologyFemalebusinessCardiology and Cardiovascular Medicineischemic LV dysfunction

description

Abstract 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.

yearjournalcountryeditionlanguage
2017-01-01
10.5167/uzh-149779https://doi.org/10.5167/uzh-149779