Clinical outcomes of percutaneous coronary intervention for chronic total occlusion in prior coronary artery bypass grafting patients
Open Access
- 4 May 2021
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 99 (1), 74-84
- https://doi.org/10.1002/ccd.29691
Abstract
Objective To compare the clinical characteristics and outcomes in patients with stable angina who have undergone chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in native arteries with or without prior coronary artery bypass grafting (CABG) surgery in a national cohort. Background There are limited data on outcomes of patients presenting with stable angina undergoing CTO PCI with previous CABG. Methods We identified 20,081 patients with stable angina who underwent CTO PCI between 2007–2014 in the British Cardiovascular Intervention Society database. Clinical, demographical, procedural and outcome data were analyzed in two groups; group 1‐CTO PCI in native arteries without prior CABG (n = 16,848), group 2‐CTO PCI in native arteries with prior CABG (n = 3,233). Results Patients in group 2 were older, had more comorbidities and higher prevalence of severe left ventricular systolic dysfunction. Following multivariable analysis, no significant difference in mortality was observed during index hospital admission (OR:1.33, CI 0.64–2.78, p = .44), at 30‐days (OR: 1.28, CI 0.79–2.06, p = .31) and 1 year (OR:1.02, CI 0.87–1.29, p = .87). Odds of in‐hospital major adverse cardiovascular events (MACE) (OR:1.01, CI 0.69–1.49, p = .95) and procedural complications (OR:1.02, CI 0.88–1.18, p = .81) were similar between two groups but procedural success rate was lower in group 2 (OR: 0.34, CI 0.31–0.39, p < .001). The adjusted risk of target vessel revascularization (TVR) remained similar between the two groups at 30‐days (OR:0.68, CI 0.40–1.16, P‐0.16) and at 1 year (OR:1.01, CI 0.83–1.22, P‐0.95). Conclusion Patients with prior CABG presenting with stable angina and treated with CTO PCI in native arteries had more co‐morbid illnesses but once these differences were adjusted for, prior CABG did not independently confer additional risk of mortality, MACE or TVR.Keywords
This publication has 30 references indexed in Scilit:
- British Cardiovascular Intervention Society registry framework: a quality improvement initiative on behalf of the National Institute of Cardiovascular Outcomes Research (NICOR)European Heart Journal - Quality of Care & Clinical Outcomes, 2019
- Meta-Analysis of Clinical Outcomes of Patients Who Underwent Percutaneous Coronary Interventions for Chronic Total OcclusionsThe American Journal of Cardiology, 2015
- Chronic Total Occlusions in Sweden – A Report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)PLOS ONE, 2014
- Quality of life benefits of percutaneous coronary intervention for chronic occlusionsCatheterization and Cardiovascular Interventions, 2013
- Impact of prior coronary artery bypass graft surgery on chronic total occlusion revascularisation: insights from a multicentre US registryHeart, 2013
- Current Perspectives on Coronary Chronic Total Occlusions: The Canadian Multicenter Chronic Total Occlusions RegistryJournal of Invasive Cardiology, 2012
- Long-Term Outcome of Percutaneous Coronary Intervention for Chronic Total OcclusionsJACC: Cardiovascular Interventions, 2011
- Percutaneous Recanalization of Chronically Occluded Coronary ArteriesJournal of the American College of Cardiology, 2005
- One-Year Coronary Bypass Graft PatencyJournal of the American College of Cardiology, 2004
- Angiographic follow-up results of a randomized study on angioplasty versus bypass surgery (GABI Trial)European Heart Journal, 1996