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Outcomes of chronic total occlusion percutaneous coronary intervention in patients with reduced left ventricular ejection fraction

  • Autori: Simsek B.; Kostantinis S.; Karacsonyi J.; Alaswad K.; Karmpaliotis D.; Masoumi A.; Jaffer F.A.; Doshi D.; Khatri J.; Poommipanit P.; Gorgulu S.; Goktekin O.; Krestyaninov O.; Davies R.; ElGuindy A.; Jefferson B.K.; Patel T.N.; Patel M.; Chandwaney R.H.; Mashayekhi K.; Galassi A.R.; Rangan B.V.; Brilakis E.S.
  • Anno di pubblicazione: 2022
  • Tipologia: Articolo in rivista
  • OA Link:


Background: The relationship between left ventricular ejection fraction (LVEF) and the success and safety of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We examined the clinical characteristics and outcomes of CTO PCI in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO) after stratifying patients by LVEF (≤35%, 36%–49%, and ≥50%). Results: A total of 7827 CTO PCI procedures with LVEF data were included. Mean age was 64 ± 10 years, 81% were men, 43% had diabetes mellitus, 61% had prior PCI, 45% had prior myocardial infarction, and 29% had prior coronary artery bypass graft surgery. Technical success was similar in the three LVEF strata: 85%, 86%, and 87%, p = 0.391 for LVEF ≤35%, 36%–49%, and ≥50%, respectively. In-hospital mortality was higher in lower LVEF patients (1.1%, 0.4%, and 0.3%, respectively, p = 0.001). In-hospital major adverse cardiovascular events (MACE) were numerically higher in lower EF patients (2.7%, 2.1%, and 1.9%, p = 0.271). At a median follow-up of 2 months (interquartile range: 19-350 days), patients with lower LVEF continued to have higher mortality (4.9%, 3.2%, and 1.4%, p < 0.001) while the MACE rates were similar (9.3%, 9.6%, and 7.4%, p = 0.172). Conclusion: CTO PCI can be performed with high technical success in patients with reduced LVEF but is associated with higher in-hospital and post-discharge mortality.