NEW ORLEANS — Patients who underwent PCI for chronic total occlusion experienced similar technical and procedural success rates regardless of the reason for the initial presentation to the hospital, according to findings presented at the American Heart Association Scientific Sessions.
The comparable success in different presentations calls into question the current practice of offering CTO only for patients with stable angina, the presenter said.
Using data from the PROGRESS-CTO registry, Judit Karacsonyi, MD, a research fellow at UT Southwestern Medical Center, and colleagues conducted an analysis of 1,268 patients who underwent PCI for chronic total occlusion. Karacsonyi told Cardiology Today that the researchers aimed to assess patient’s symptoms prior to treatment and to determine if there were any differences in in-hospital technical or procedural successes.
The researchers divided the participants into five groups based on their clinical presentation. More than half (59%) of patients presented with stable angina; 21.9% had unstable angina; 1.5% had STEMI; 6.4% had non-STEMI and; 11.2% had symptoms unlikely to be ischemic or had no symptoms.
“We found that there was no difference between the technical success, procedural success and major cardiac adverse events,” Karacsonyi said.
Overall, patients had a technical success rate of 88.55% and a procedural success rate of 86.65%. Patients who presented with unstable angina had the best technical success rate (90.37%) and procedural success rate (88.1%) out of the patients who experienced any symptoms. However, the differences were not significant.
Patients who presented with stable angina had similar technical success (87.02%) and procedural success (85.46%) rates, as did patients who presented with non-STEMI (90.12%, 88.89%).
The highest occurrence of MACE was in patients who presented with STEMI (5.26%).
“If we have experienced CTO operators in high volume centers, then we can reach high success and low complication rates regardless of the presentation,” Karacsonyi said. “Which is quite surprising because the current practice is to do PCI for CTO only in patients with stable angina.” – by Ryan McDonald
Karacsonyi J, et al. S4288. Presented at: American Heart Association Scientific Sessions; Nov. 12-16, 2016; New Orleans.
Disclosure: Karacsonyi reports no relevant financial disclosures. Please see the full study for a list of all other relevant financial disclosures.