Prognostic Impact of Percutaneous Coronary Intervention of Chronic Total Occlusion in Acute and Periprocedural Myocardial Infarction
Abstract
1. Introduction
2. Pathophysiologic Role of CTO and Collateral Supply in AMI Patients
2.1. Pathophysiology of Coronary Collateral Connections
2.2. Pathological Mechanism of CTO in Patients with AMI
3. CTO-PCI in Patients with AMI
3.1. CTO in STEMI
3.2. CTO in STEMI Complicated by Cardiogenic Shock
3.3. CTO in NSTEMI
4. PMI Caused by CTO-PCI
4.1. Definition and Pathological Mechanism of PMI Caused by CTO-PCI
4.2. Prognostic Impact of PMI Caused by CTO-PCI
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Elias et al. [55] | Yang et al. [59] | Shi et al. [60] | Valenti et al. [61] | Deng et al. [62] | |
---|---|---|---|---|---|
Study design | Randomized controlled trial | Retrospective cohort study | Retrospective cohort study | Retrospective cohort study | Retrospective cohort study |
Number of CTO patients | 302 | 136 | 152 | 169 | 377 |
Duration of follow up (median) | 48 months | 24 months | 36 months | 36 months | 12 months |
Success rate of CTO-PCI (%) | 73 | 64 | 68 | 78 | 79 |
Time interval between primary PCI and staged PCI (days) | 5 ± 2 | 7–10 | 7–10 | Up to 30 | 7–28 |
All-cause Mortality (%) (CTO-PCI vs. control) | 12.9 vs. 6.2, p = 0.11 | — | — | 3.4 vs. 15.0, p = 0.02 | 4.1 vs. 15.4, p < 0.001 |
Cardiac Mortality (%) (CTO-PCI vs. control) | 6.0 vs. 1.0, p = 0.02 | 8.0 vs. 20.4, p = 0.036 | 9.0 vs. 22.9, p = 0.02 | 1.7 vs. 12, p = 0.025 | 3.6 vs. 15.0, p < 0.001 |
MACE (%) (CTO-PCI vs. control) | 13.5 vs. 12.3, p = 0.93 | 21.8 vs. 38.8, p = 0.042 | 28.0 vs. 50.0, p = 0.009 | — | 4.6 vs. 19.5, p < 0.001 |
Lee et al. [55] | Zhang et al. [61] | Kim et al. [59] | Lo et al. [60] | |
---|---|---|---|---|
Study design | Retrospective cohort study | Prospective cohort study | Prospective cohort study | Retrospective cohort study |
Number of CTO patients | 1058 | 629 | 337 | 325 |
Duration of follow up (median) | 52 months | 12 months | 30 months | 28 months |
Definition of PMI | CK-MB ≥ 3xURL | CK-MB ≥ 3xURL | CK-MB ≥ 3xURL | CK-MB ≥ 3xURL |
Rate of PMI (%) | 11.4 | 18.3 | 6.8 | 8.6 |
Association of retrograde approach with PMI | OR: 2.27, p = 0.002 | OR: 1.35, p = 0.04 | No association found | 13.8% vs. 6.7%, p = 0.044 |
All-cause mortality (PMI vs. non-PMI) | HR: 1.96, p = 0.01 | 2.6% vs. 1.0%, p = 0.16 | HR: 4.35, p = 0.048 | — |
Cardiac Mortality (PMI vs. non-PMI) | HR: 1.92, p = 0.04 | 2.6% vs. 0.8%, p = 0.09 | HR: 13.3, p = 0.001 | — |
MACE (PMI vs. non-PMI) | — | 12.2% vs. 4.1%, p = 0.001 | HR: 5.2, p = 0.002 | HR: 2.25, p = 0.006 |
Jang et al. [55] | Jaguszewski et al. [59] | Cottens et al. [60] | |
---|---|---|---|
Study design | Retrospective cohort study | Prospective cohort study | Retrospective cohort study |
Number of CTO patients | 927 | 1110 | 409 |
Duration of follow up (median) | 42 months | 65 months | 12 months |
Definition of PMI | hs-TnI ≥ 5xURL | hs-TnI ≥ 5xURL | hs-TnT ≥ 5xURL |
Rate of PMI (%) | 12.7 | 4.7 | 42 |
Association of retrograde approach with PMI | No association found | No association found | OR: 1.2,p = 0.04 |
All-cause mortality (PMI vs. non-PMI) | HR: 1.58, p = 0.31 | HR: 1.45, p = 0.33 | — |
Cardiac Mortality (PMI vs. non-PMI) | HR: 1.72, p = 0.39 | HR: 2.51, p = 0.05 | — |
MACE (PMI vs. non-PMI) | HR: 1.10, p = 0.75 | HR: 1.19, p = 0.49 | HR: 1.37, p = 0.45 |
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Kim, S.-H.; Behnes, M.; Mashayekhi, K.; Bufe, A.; Meyer-Gessner, M.; El-Battrawy, I.; Akin, I. Prognostic Impact of Percutaneous Coronary Intervention of Chronic Total Occlusion in Acute and Periprocedural Myocardial Infarction. J. Clin. Med. 2021, 10, 258. https://doi.org/10.3390/jcm10020258
Kim S-H, Behnes M, Mashayekhi K, Bufe A, Meyer-Gessner M, El-Battrawy I, Akin I. Prognostic Impact of Percutaneous Coronary Intervention of Chronic Total Occlusion in Acute and Periprocedural Myocardial Infarction. Journal of Clinical Medicine. 2021; 10(2):258. https://doi.org/10.3390/jcm10020258
Chicago/Turabian StyleKim, Seung-Hyun, Michael Behnes, Kambis Mashayekhi, Alexander Bufe, Markus Meyer-Gessner, Ibrahim El-Battrawy, and Ibrahim Akin. 2021. "Prognostic Impact of Percutaneous Coronary Intervention of Chronic Total Occlusion in Acute and Periprocedural Myocardial Infarction" Journal of Clinical Medicine 10, no. 2: 258. https://doi.org/10.3390/jcm10020258
APA StyleKim, S.-H., Behnes, M., Mashayekhi, K., Bufe, A., Meyer-Gessner, M., El-Battrawy, I., & Akin, I. (2021). Prognostic Impact of Percutaneous Coronary Intervention of Chronic Total Occlusion in Acute and Periprocedural Myocardial Infarction. Journal of Clinical Medicine, 10(2), 258. https://doi.org/10.3390/jcm10020258