Abstract 20929: Impact of Complete Revascularization on Long-Term Clinical Outcomes in Patients With Multi-Vessel Disease Including Chronic Total Occlusion

Abstract

Introduction: Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher recurrence. Also, it is not clear whether the complete revascularization will significantly improve the angiographic and clinical outcomes in patients with multi-vessel disease (MVD) including CTO. Hypothesis: We assessed that the impact of complete revascularization on long-term clinical outcomes in patients with MVD including CTO. Methods: A total of 559 CTO patients with MVD who underwent percutaneous coronary intervention (PCI) for CTO lesion at Sejong General Hospital and Korea University Guro Hospital were enrolled and divided into two groups according to complete revascularization (CTO-PCI; n=325) or not (optimal medial therapy for non-CTO lesion, CTO-OMT; n=234). To adjust potential confounders, a propensity score matching (PSM) analysis was performed. The individual and composite major clinical outcomes were compared between the two groups up to 5 years. Results: After PSM analysis, two PSM groups (186 pairs, total=372) were generated and the baseline characteristics were balanced. Although the CTO-PCI group showed a higher incidence of target lesion and vessel revascularization (TLR and TVR) on CTO, there was a trend toward lower incidence of myocardial infarction (MI) and the incidence of total death or myocardial infarction (MI) was lower in the CTO-PCI group compared with the CTO-OMT group up to 5 years (Table). Conclusions: In the present study, successful CTO-PCI was associated with a lower trend of MI as well as reduction of the risk of total death or MI up to 5-year in CTO patients with MVD regardless of treatment strategy for the non-CTO target vessel.