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August 11, 2017

OPEN-CTO Registry Evaluates Early Procedural and Health Status Outcomes After PCI for CTOs

August 11, 2017—Findings on early procedural and health status outcomes after chronic total occlusion (CTO) angioplasty in the OPEN-CTO registry were published online by James Sapontis, MD, et al in Journal of the American College of Cardiology (JACC): Cardiovascular Interventions.

According to the investigators, this study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary CTO percutaneous coronary intervention (PCI). Using a uniquely comprehensive, core lab–adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, the investigators evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully versus unsuccessfully treated patients.

As summarized in JACC: Cardiovascular Interventions, the investigators found that technical success was high (86%). In-hospital mortality was 0.9% and 1-month mortality was 1.3%. Perforations requiring treatment occurred in 48 patients (4.8%).

Among those patients who survived and completed the 1-month follow-up (n = 947), mean ± SEM (standard error of the mean) Seattle Angina Questionnaire quality-of-life scores improved from 49.4 ± 0.9 to 75.0 ± 0.7 (P < .01), mean Rose Dyspnea Scale scores improved (decreased) from 2.0 ± 0.1 to 1.1 ± 0.1 (P < .01), and physician health questionnaire (for depression) scores improved (decreased) from 6.2 ± 0.2 to 3.5 ± 0.1 (P < .01) at 1 month.

After adjusting for baseline differences the mean group difference in Seattle Angina Questionnaire quality of life between successful and unsuccessful CTO PCI was 10.8 (95% confidence interval, 6.3–15.3; P < .001.

Clarifying the success rates, risks, and benefits of CTO PCI will help to more accurately contextualize the informed consent process for these procedures so that patients with appropriate indications for CTO PCI can more effectively share in the decision to pursue this or other therapeutic options, concluded the investigators in JACC: Cardiovascular Interventions.

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