Key result
Successful PCI using drug-eluting stents for chronic total occlusions was associated with lower long-term all-cause mortality compared to failed PCI (OR 0.55; 95% CI 0.45-0.67; P<0.001).
Why the study?
Does successful percutaneous coronary intervention using drug-eluting stents improve long-term clinical outcomes in patients with chronic total occlusions compared to failed procedures?
Meta-Analysis (n=7,469)
Does successful percutaneous coronary intervention using drug-eluting stents improve long-term clinical outcomes in patients with chronic total occlusions compared to failed procedures?
Odds Ratio: 0.55 (95% CI 0.45–0.67)
p-value: p=< 0.001
Successful revascularization of chronic total occlusions with drug-eluting stents is associated with significantly lower long-term mortality, MI, and MACE compared to failed procedures.
OBJECTIVES: To determine whether successful percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) have beneficial effects on long-term outcomes in patients with chronic total occlusions (CTOs) compared with failed PCIs for CTOs. BACKGROUND: Several observational studies have evaluated the long-term clinical outcomes of successful PCIs using DESs for CTOs. However, the results of these studies were inconsistent and inconclusive. METHODS: We searched five online electronic databases to identify all the publications assessing the long-term outcomes of successful and failed PCIs using DESs for CTOs. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by STATA software. RESULTS: A total of nine studies involving 5958 CTO patients who underwent successful PCI and 1511 CTO patients who underwent failed PCI were included in this meta-analysis. The results of the analysis indicated that successful CTO PCIs using DESs were associated with lower long-term all-cause mortality(OR = 0.55, 95% CI = 0.45-0.67, P < 0.001), lower risk of myocardial infarction (OR = 0.45, 95% CI = 0.23-0.74, P = 0.002), lower risk of major adverse cardiac events (MACEs, OR = 0.44, 95% CI = 0.27-0.72, P = 0.001), and less incidence of subsequent coronary artery bypass grafting (OR = 0.10, 95% CI = 0.05-0.21, P < 0.001) than failed CTO PCIs. However, there was no difference in the incidence of target vessel revascularization (OR = 1.06, 95% CI = 0.17-6.60, P > 0.05) between the two groups. CONCLUSION: Successful CTO PCI using DESs can reduce long-term all-cause mortality and the risks of MI, MACEs, and CABG in patients with CTOs.
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Gao et al. (2017) conducted a meta-analysis in Chronic total occlusions (CTOs) (n=7,469). Successful percutaneous coronary intervention (PCI) using drug-eluting stents vs. Failed PCI was evaluated on Long-term all-cause mortality (OR 0.55, 95% CI 0.45-0.67, p=< 0.001). Successful PCI using drug-eluting stents for chronic total occlusions was associated with lower long-term all-cause mortality compared to failed PCI (OR 0.55; 95% CI 0.45-0.67; P<0.001).
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