Back to Search
Start Over
Management strategies in patients affected by chronic total occlusions: results from the Italian Registry of Chronic Total Occlusions.
- Source :
-
European heart journal [Eur Heart J] 2015 Dec 01; Vol. 36 (45), pp. 3189-98. Date of Electronic Publication: 2015 Sep 02. - Publication Year :
- 2015
-
Abstract
- Background: Through contemporary literature, the optimal strategy to manage coronary chronic total occlusions (CTOs) remains under debate.<br />Objectives: The aim of the Italian Registry of Chronic Total Occlusions (IRCTO) was to provide data on prevalence, characteristics, and outcome of CTO patients according to the management strategy.<br />Methods: The IRCTO is a prospective real world multicentre registry enrolling patients showing at least one CTO. Clinical and angiographic data were collected independently from the therapeutic strategy [optimal medical therapy (MT), percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG)]; a comparative 1-year clinical follow-up was performed.<br />Results: A total of 1777 patients were enrolled for an overall CTO prevalence of 13.3%. The adopted therapeutic strategies were as follows: MT in 826 patients (46.5%), PCI in 776 patients (43.7%), and CABG in the remaining 175 patients (9.8%). At 1-year follow-up, patients undergoing PCI showed lower rate of major adverse cardiac and cerebrovascular events (MACCE) (2.6% vs. 8.2% and vs. 6.9%; P < 0.001 and P < 0.01) and cardiac death (1.4% vs. 4.7% and vs. 6.3%; P < 0.001 and P < 0.001) in comparison with those treated with MT and CABG, respectively. After propensity score-matching analysis, patients treated with PCI showed lower incidence of cardiac death (1.5 vs. 4.4%; P < 0.001), acute myocardial infarction (1.1 vs. 2.9%; P = 0.03), and re-hospitalization (2.3 vs. 4.4% P = 0.04) in comparison with those managed by MT.<br />Conclusions: Our data showed how CTO PCI might significantly improve the survival and decrease MACCE occurrence at 1 year follow-up in comparison with MT and/or CABG.<br /> (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)
- Subjects :
- Aged
Cardiovascular Agents therapeutic use
Chronic Disease
Coronary Angiography mortality
Coronary Artery Bypass mortality
Coronary Artery Bypass statistics & numerical data
Coronary Occlusion mortality
Female
Humans
Italy epidemiology
Male
Percutaneous Coronary Intervention mortality
Percutaneous Coronary Intervention statistics & numerical data
Prevalence
Prospective Studies
Registries
Treatment Outcome
Ventricular Dysfunction, Left mortality
Ventricular Dysfunction, Left therapy
Coronary Occlusion therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1522-9645
- Volume :
- 36
- Issue :
- 45
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 26333367
- Full Text :
- https://doi.org/10.1093/eurheartj/ehv450