C-42 | In-Hospital Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients With History of Ventricular Tachycardia: National Inpatient Sample Database Analysis.

Chronic Total Occlusion Percutaneous Coronary Intervention (CTO-PCI) poses a distinct technical challenge with increased risk of periprocedural complications with unclear benefits. We sought to explore its effect in patients with a history of Ventricular Tachycardia (VT). National Inpatient Sample (2016-2020) was queried to identify adults with CTO and VT, which were stratified based on PCI using ICD-10-CM and PCS codes. All patients with acute myocardial infarction were excluded. Controls were derived using propensity score matching for demographics and comorbidities. The outcomes were inpatient mortality and complications, length of stay (LOS), and total hospital charge (THC). Multivariate logistic and linear regression analyses were used. Of 31,870 patients with CTO and VT, 6,395 underwent PCI. A five-year trend analysis showed reducing trends of patients with CTO and VT undergoing PCI (23.3% to 17.0%) (p=0.001). Upon matched analyses, Patients with VT and CTO-PCI showed similar adjusted odds of inpatient mortality (adjusted odd ratio [aOR] 1.31, 95% CI [0.99-1.74], p=0.063), but higher odds of cardiac arrest, cardiogenic shock requiring vasopressors and mechanical circulatory support. Table 1 shows multivariate logistic regression of outcomes in propensity-matched and unmatched groups. PCI-CTO in patients with a history of VT has similar in-hospital mortality. However, they had higher life-threatening cardiac complications requiring circulatory support likely owing to their advanced cardiomyopathy.