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Percutaneous coronary interventions and cardiovascular outcomes for patients with chronic total occlusions.

Publication ,  Journal Article
Jolicœur, EM; Sketch, MJ; Wojdyla, DM; Javaheri, SP; Nosib, S; Lokhnygina, Y; Patel, MR; Shaw, LK; Tcheng, JE
Published in: Catheter Cardiovasc Interv
March 1, 2012

OBJECTIVES: This study sought to assess the benefits of a coronary chronic total occlusion CTO recanalization after adjusting for the case-mix and the propensity to undergo the CTO intervention in a population of patients with stable coronary artery disease. BACKGROUND: The benefits of percutaneous recanalization of CTO are disputed. METHODS: In 1,602 patients with a least one CTO and treated by percutaneous coronary intervention (PCI), we derived a propensity score to undergo a CTO recanalization by comparing the characteristics of patients who did (n = 346) and did not (n = 1,256) undergo a CTO PCI attempt. Among the patients who underwent a CTO PCI attempt, we identified the angiographic predictors of failure. The primary analysis was ultimately performed by looking at the association between the outcome of the CTO recanalization and the survival free of death and cardiovascular rehospitalizations. Sensitivity analyses were performed by adjusting for the propensity to undergo a CTO recanalization, for the anatomical predictors of failure, and for the extent of coronary artery revascularization achieved. RESULTS: A successful CTO recanalization was not significantly associated with survival free of death and cardiovascular rehospitalization (HR = 0.90, 95% CI 0.64-1.25). Even more conservative hazards ratio point estimates were obtained with the sensitivity analyses. CONCLUSIONS: Successful percutaneous CTO recanalization is not associated with survival free of death and cardiovascular hospitalizations in a contemporary population of patients with symptomatic coronary artery disease.

Duke Scholars

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

March 1, 2012

Volume

79

Issue

4

Start / End Page

603 / 612

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Proportional Hazards Models
  • Propensity Score
  • Predictive Value of Tests
  • Patient Readmission
  • North Carolina
 

Citation

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ICMJE
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Jolicœur, E. M., Sketch, M. J., Wojdyla, D. M., Javaheri, S. P., Nosib, S., Lokhnygina, Y., … Tcheng, J. E. (2012). Percutaneous coronary interventions and cardiovascular outcomes for patients with chronic total occlusions. Catheter Cardiovasc Interv, 79(4), 603–612. https://doi.org/10.1002/ccd.23269
Jolicœur, E Marc, Micheal J. Sketch, Daniel M. Wojdyla, Sean P. Javaheri, Shravan Nosib, Yuliya Lokhnygina, Manesh R. Patel, Linda K. Shaw, and James E. Tcheng. “Percutaneous coronary interventions and cardiovascular outcomes for patients with chronic total occlusions.Catheter Cardiovasc Interv 79, no. 4 (March 1, 2012): 603–12. https://doi.org/10.1002/ccd.23269.
Jolicœur EM, Sketch MJ, Wojdyla DM, Javaheri SP, Nosib S, Lokhnygina Y, et al. Percutaneous coronary interventions and cardiovascular outcomes for patients with chronic total occlusions. Catheter Cardiovasc Interv. 2012 Mar 1;79(4):603–12.
Jolicœur, E. Marc, et al. “Percutaneous coronary interventions and cardiovascular outcomes for patients with chronic total occlusions.Catheter Cardiovasc Interv, vol. 79, no. 4, Mar. 2012, pp. 603–12. Pubmed, doi:10.1002/ccd.23269.
Jolicœur EM, Sketch MJ, Wojdyla DM, Javaheri SP, Nosib S, Lokhnygina Y, Patel MR, Shaw LK, Tcheng JE. Percutaneous coronary interventions and cardiovascular outcomes for patients with chronic total occlusions. Catheter Cardiovasc Interv. 2012 Mar 1;79(4):603–612.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

March 1, 2012

Volume

79

Issue

4

Start / End Page

603 / 612

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Proportional Hazards Models
  • Propensity Score
  • Predictive Value of Tests
  • Patient Readmission
  • North Carolina