Timing of chronic total occlusion percutaneous coronary intervention in acute coronary syndromes: Early versus late complete revascularization and clinical outcomes
Abstract
Methods
We conducted a retrospective, multicenter analysis of patients with ACS who underwent successful percutaneous coronary intervention (PCI) of the culprit lesion and later underwent CTO-PCI of a non-culprit lesion as part of a complete revascularization strategy. Patients were divided into two groups: “early CTO-PCI” (≤45 days) and “late CTO-PCI” (> 45 days to ≤ 6 months). The primary endpoint was a composite of all-cause death, myocardial infarction, any revascularization, and cardiac re-hospitalization.
Results
Overall, 215 patients were included (119 early CTO-PCI, 96 late CTO-PCI). Patients in the late CTO-PCI group had more complex procedural features, reduced
ventricular function, and a higher prevalence of demonstrable myocardial viability. The incidence of the primary outcome was comparable between the two groups at three years of follow-up (HR 0.94, 95 % CI 0.52–1.62). The same results were evident for its individual components, in sensitivity analysis at one year of follow-up, and after adjusting for major confounders.