Impact of Periprocedural Myocardial Infarction Following Chronic Total Occlusion Interventions on Mid-term Angiographic and 2-year Clinical Outcomes

Abstract

Table 6-to-9 month angiographic and 2-year clinical outcomes Variables, n (%) De Novo CTO (n1⁄4249) stented CTO (n1⁄420) P* value 6 to-9 month Angiographic outcomes n1⁄4146 n1⁄47 In-stent restenosis 44 (30.1) 2 (28.6) 0.647 Binary restenosis 22 (15.1) 2 (28.6) 0.302 2-yearclinical outcomes n1⁄4209 n1⁄417 All death 8 (3.8) 1 (5.9) 0.512 Any myocardial infarction 6 (2.9) 0 (0.0) 0.622 Any Revascularization 37 (17.7) 2 (11.8) 0.410 TLR 28 (13.4) 1 (5.9) 0.328 TVR 32 (15.3) 2 (11.8) 0.513 Non-TVR 5 (2.4) 0 (0.0) 0.674 Total MACE 44 (21.1) 3 (17.6) 0.513 TLR MACE 32 (15.3) 1 (5.9) 0.256 TVR MACE 40 (19.1) 3 (17.6) 0.589 Stent thrombosis 0 (0.0) 1 (0.4) 0.922 * Fisher exact test. Table Six month angiographic and 24 month clinical outcomes 6 Month Angiographic Outcomes P-MI (n 1⁄4 12 pts) Control (n 1⁄4 119 pts) P-value Binary restenosis (>50%) 1/8 (12.5) 9/64 (14) 0.904 Mean DS% 31.61 27.37 26.10 23.71 0.239 FU MLD (mm) 2.024 0.852 2.219 0.757 0.183 Late Loss (mm) 0.676 0.788 0.564 0.707 0.409 24-Month Clinical Outcomes P-value Total death 3 (25) 1 (0.8) <0.001 Cardiac death 1 (8.3) 0 (0) 0.0016 Any MI 1 (8.3) 1 (0.8) 0.0436 Q wave 1 (8.3) 1 (0.8) 0.0436 Repeat PTCA 2 (16.6) 14 (11.7) 0.6211 TLR 2 (16.6) 10 (8.4) 0.3443 TVR 2 (16.6) 11 (9.2) 0.4124 All MACE 4 (33.3) 15 (12.6) 0.0520 TLR MACE 2 (16.6) 10 (8.4) 0.3443 TVR MACE 4 (33.3) 13 (10 9) 0.0277 AS-150 Impact of Periprocedural Myocardial Infarction Following Chronic Total Occlusion Interventions on Mid-term Angiographic and 2-year Clinical Outcomes. Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Sung Il Im, Sun Won Kim, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh. Korea University Guro Hospital, Seoul, Korea (Republic of). 74B The American Journal of Cardiology APRIL 2 Background: Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher recurrence. It is not clear whether the peri-procedural myocardial infarction (P-MI) will significantly impact on angiographic and clinical outcomes following CTO intervention. Methods: A total of 131 consecutive pts underwent CTO intervention were divided into P-MI (n1⁄412) and control group (n1⁄4119). Sixmonth angiographic and twelve-month clinical outcomes were compared between the two groups. Results: The baseline clinical characteristics were balanced between the two groups except more elderly (66.1 13.0 vs. 60.1 9.4 p1⁄40.034) in the P-MI group. There were higher incidence of perforation (15.3% vs. 0.7%, p1⁄40.0005), dissection (46.1% vs. 18.1%, p1⁄40.018), any hematoma and acute renal failure in the P-MI group. Angiographic outcomes at 6 months were not different between the two groups. However, the incidence of total death, any myocardial infarction (MI) and target vessel revascularization (TVR)-major adverse cardiac events (MACE) were higher in the P-MI group at 24 months. Conclusion: P-MI following CTO intervention was associated with higher 2-year mortality, any MI and TVR-MACE. Careful procedure to minimize P-MI will be warranted to get optimal CTO intervention outcomes. 3e26, 2013 ANGIOPLASTY SUMMIT ABSTRACTS/Poster