Abstract 14495: Impact of Complete Revascularization in Chronic Total Occlusion Patients With Multi-Vessel Disease on Long-Term Clinical Outcomes

Abstract

Background: This study compares the long-term clinical outcomes between two different treatment strategies: percutaneous coronary intervention (PCI) versus medical therapy (MT) for chronic total occlusion (CTO) in multi-vessel disease (MVD) patients. Methods: The study data obtained from the CTO registry of Korea University Guro Hospital (KUGH), Seoul, South Korea. This trial is a single-center, prospective, all-comer registry designed to reflect “real world” practice since 2004. the study population has been divided into two groups: the CTO-PCI group having 233 patients and the CTO-MT group having 230 patients. A propensity score matching (PSM) analysis had performed to adjust for confounding factors. Results: Following PSM, the two groups comprised the matched individuals from 336 pairs (total N=272 patients). The baseline clinical and angiographic characteristics were well-balanced between the two groups. Up to a 5-year clinical follow-up by Kaplan-Meier survival analysis, the primary endpoint, as defined as the composite of all-cause death or myocardial infarction (MI), occurred more in the CTO-MT group (32.6%) than in the PCI group (2.3%), as did all-cause death (2.3% vs. 8.4%, P=0.042) and MI (4.3% vs. 0.0%, P= 0.023). Target vessel revascularization (TVR) at CTO lesions still occurred more in the CTO-PCI group than in the CTO-MT group (38.3% vs. 6.8%, P=0.009). Conclusions: PCI is shown as a reasonable treatment option compared to MT for CTO lesions in MVD patients; TVR risk is still higher, although.