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Open AccessArticle

Predictors for Target Vessel Failure after Recanalization of Chronic Total Occlusions in Patients Undergoing Surveillance Coronary Angiography

1
Center for Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
2
Center for Thrombosis and Hemostasis, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, Langenbeckstr 1, 55131 Mainz, Germany
3
German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Langenbeckstr. 1, 55131 Mainz, Germany
*
Authors to whom correspondence should be addressed.
M.G. and J.W. contributed equally and should both be considered as first authors.
J. Clin. Med. 2020, 9(1), 178; https://doi.org/10.3390/jcm9010178
Received: 24 November 2019 / Revised: 3 January 2020 / Accepted: 7 January 2020 / Published: 9 January 2020
(1) Background: Knowledge about predictors for the long-time patency of recanalized chronic total coronary occlusions (CTOs) is limited. Evidence from invasive follow-up in the absence of acute coronary syndrome (routine surveillance coronary angiography) is scarce. (2) Methods: In a monocentric-retrospective analysis, we obtained baseline as well as periprocedural data of patients undergoing routine invasive follow-up. We defined target vessel failure (TVF) as a combined primary endpoint, consisting of re-occlusion, restenosis, and target vessel revascularization (TVR). (3) Results: We included 93 consecutive patients (15.1% female) from October 2013 to May 2018. After a follow-up period of 206 ± 129 days (median 185 (IQR 127–237)), re-occlusion had occurred in 7.5%, restenosis in 11.8%, and TVR in 5.4%; the cumulative incidence of TVF was 15.1%. Reduced TIMI-flow immediately after recanalization (OR for TVR: 11.0 (95% CI: 2.7–45.5), p = 0.001) as well as female gender (OR for TVR: 11.0 (95% CI: 2.1–58.5), p = 0.005) were found to be predictive for pathological angiographic findings at follow-up. Furthermore, higher blood values of high-sensitive troponin after successful revascularization were associated with all endpoints. Interestingly, neither the J-CTO score nor the presence of symptoms at the follow-up visit could be correlated to adverse angiographic results. (4) Conclusions: In this medium-sized cohort of patients with surveillance coronary angiography, we were able to identify reduced TIMI flow and female gender as the strongest predictors for future TVF. View Full-Text
Keywords: chronic total occlusion; target vessel failure; re-occlusion; surveillance coronary angiography chronic total occlusion; target vessel failure; re-occlusion; surveillance coronary angiography
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Geyer, M.; Wild, J.; Hirschmann, M.; Dimitriadis, Z.; Münzel, T.; Gori, T.; Wenzel, P. Predictors for Target Vessel Failure after Recanalization of Chronic Total Occlusions in Patients Undergoing Surveillance Coronary Angiography. J. Clin. Med. 2020, 9, 178.

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