Reduced LVEF (≤40%) in patients with coronary chronic total occlusion was associated with higher 3-year all-cause mortality compared to mildly reduced (P=0.004) and preserved LVEF (P<0.001).
Cohort (n=1,255)
No
Does baseline LVEF category impact 3-year clinical outcomes in patients with coronary chronic total occlusion?
In patients with coronary chronic total occlusion, reduced LVEF (≤40%) is associated with higher all-cause mortality compared to mildly reduced or preserved LVEF, while mildly reduced LVEF is associated with higher revascularization rates than preserved LVEF.
p-value: p=0.004 and <0.001
Left ventricular ejection fraction (LVEF) is a key determinant of prognosis in patients with coronary artery disease. However, the impact of LVEF categories on long-term outcomes in patients with coronary chronic total occlusion (CTO) remains underexplored. This study aimed to evaluate the 3-year clinical outcomes in CTO patients according to LVEF category. We retrospectively analyzed 1255 patients with coronary CTO, categorized into 3 groups based on LVEF: reduced (rEF, ≤40%), mildly reduced (mrEF, 41–49%), and preserved (pEF, ≥50%). The primary outcome was all-cause mortality. Secondary outcomes included cardiac death (CD), non-CD, myocardial infarction, and any revascularization, including target lesion revascularization (CTO vessels), target vessel revascularization (TVR and CTO vessels), and nontarget vessel revascularization (non-TVR and non-CTO vessels). After adjustment, all-cause mortality ( P = .004 and P < .001, respectively) and CD ( P = .005 and P < .001, respectively) were significantly higher in the rEF group compared with the mrEF and pEF groups. The mrEF group had significantly higher rates of any revascularization ( P < .001), target lesion revascularization (CTO vessel, P = .024), and TVR (CTO vessel, P = .001) than the pEF group. These findings remained consistent even when the analysis was confined to patients who underwent percutaneous coronary intervention. In this single-center study of patients with coronary CTO, all-cause mortality was higher in the rEF group than in the mrEF and pEF groups, whereas no significant difference was observed between the mrEF and pEF groups. However, the mrEF group had a higher rate of any revascularization than the pEF group.
Kim et al. (2026) conducted a cohort in coronary chronic total occlusion (n=1,255). Reduced left ventricular ejection fraction (rEF, ≤40%) vs. Mildly reduced (41-49%) and preserved (≥50%) LVEF was evaluated on all-cause mortality (p=0.004 and <0.001). Reduced LVEF (≤40%) in patients with coronary chronic total occlusion was associated with higher 3-year all-cause mortality compared to mildly reduced (P=0.004) and preserved LVEF (P<0.001).