Abstract 9961: Benefits of Successful Percutaneous Coronary Intervention in Chinese CTO Patients With Low LVEF

Abstract

Introduction: Low left ventricular ejection fraction (LVEF) was commonly seen in chronic total occlusion (CTO) patients and was considered as an independent risk factor of poor prognosis of those patients. Yet, data regarding the clinical outcome, symptom and quality of life (QOL) of successful recanalization of CTO in low LVEF patients were scarcely reported. Objectives: This study set out to assess the clinical outcome, symptoms and QOL of CTO treated with percutaneous coronary intervention (CTO-PCI) in Chinese patients with low LVEF. Methods: Patients consecutively undergoing elective CTO-PCI were included and subdivided into 3 groups: LVEF≥50%, 50%>LVEF≥40%, and LVEF<40%. Detailed baseline characteristics, assessment of symptoms and QOL, procedural details, in-hospital complications, and 1 month and 1 year follow-up data were collected. Results: Of 995 CTO patients, LVEF<40% was present in 172 (17.29%), who had more previous MI, multi-CTO lesion and higher SYNTAX score (p<0.001), and their procedural success rate did not drop significantly compared with the other two groups (93.95% vs. 92.31% vs. 88.95%; p=0.078). In-hospital MACCE (2.55% vs. 2.56 vs. 8.14%; p=0.001) was the highest in patients with LVEF<40%. At 1 month and 1 year follow-up, MACE and all-cause mortality were also the highest in patients with LVEF<40% after successful CTO-PCI, while they were markedly lower than those with failed CTO-PCI (p<0.001). LVEF<40% was an independent risk factor of MACE and all-cause mortality 1 year after successful revascularization. Symptoms and QOL were markedly improved regardless of LVEF at 1 month and 1 year follow-up, notably at a similar degree between patients with LVEF<40% and the other two groups (P>0.05). Conclusions: PCI could represent an effective revascularization strategy improving clinical outcome, symptoms and QOL in CTO patients with low LVEF.