CTO PCI in patients with LVEF ≤35% achieved similar technical success (85% vs 87%, p=0.391) compared to LVEF ≥50%, but was associated with higher in-hospital mortality (1.1% vs 0.3%, p=0.001).
Observational (n=7,827)
Yes
Does baseline LVEF affect the technical success and safety of CTO PCI?
CTO PCI achieves similar technical success in patients with reduced LVEF compared to those with preserved LVEF, though patients with reduced LVEF face higher mortality risks.
Absolute Event Rate: 85% vs 87%
p-value: p=0.391
BACKGROUND: The relationship between left ventricular ejection fraction (LVEF) and the success and safety of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We examined the clinical characteristics and outcomes of CTO PCI in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO) after stratifying patients by LVEF (≤35%, 36%-49%, and ≥50%). RESULTS: A total of 7827 CTO PCI procedures with LVEF data were included. Mean age was 64 ± 10 years, 81% were men, 43% had diabetes mellitus, 61% had prior PCI, 45% had prior myocardial infarction, and 29% had prior coronary artery bypass graft surgery. Technical success was similar in the three LVEF strata: 85%, 86%, and 87%, p = 0.391 for LVEF ≤35%, 36%-49%, and ≥50%, respectively. In-hospital mortality was higher in lower LVEF patients (1.1%, 0.4%, and 0.3%, respectively, p = 0.001). In-hospital major adverse cardiovascular events (MACE) were numerically higher in lower EF patients (2.7%, 2.1%, and 1.9%, p = 0.271). At a median follow-up of 2 months (interquartile range: 19-350 days), patients with lower LVEF continued to have higher mortality (4.9%, 3.2%, and 1.4%, p < 0.001) while the MACE rates were similar (9.3%, 9.6%, and 7.4%, p = 0.172). CONCLUSION: CTO PCI can be performed with high technical success in patients with reduced LVEF but is associated with higher in-hospital and post-discharge mortality.
Simsek et al. (Sun,) conducted a observational in Coronary chronic total occlusion (n=7,827). CTO PCI (LVEF ≤35%) vs. CTO PCI (LVEF 36%-49% and ≥50%) was evaluated on Technical success (p=0.391). CTO PCI in patients with LVEF ≤35% achieved similar technical success (85% vs 87%, p=0.391) compared to LVEF ≥50%, but was associated with higher in-hospital mortality (1.1% vs 0.3%, p=0.001).