Vinoda Sharma
Chronic total occlusion in non-ST elevation myocardial infarction - A multi-centre observational study.
Sharma, Vinoda; Choudhury, Anirban; Basavarajaiah, Sandeep; Rashid, Muhammad; Yuan, Mengshi; Jefferey, Daniel; Vanezis, Andrew P; Sall, Hanish; Smith, William H T; Parasa, Ramya; Kelly, Paul; Kinnaird, Tim; Mamas, Mamas A
Authors
Anirban Choudhury
Sandeep Basavarajaiah
Muhammad Rashid m.rashid@keele.ac.uk
Mengshi Yuan
Daniel Jefferey
Andrew P Vanezis
Hanish Sall
William H T Smith
Ramya Parasa
Paul Kelly
Tim Kinnaird
Mamas Mamas m.mamas@keele.ac.uk
Abstract
Objectives
To evaluate the characteristics and outcomes of patients with a chronic total occlusion (CTO) in a Non-ST Elevation Myocardial Infarction (NSTEMI) cohort.
Background
There is limited data on the clinical characteristics, revascularisation strategies and outcomes of patients presenting with a NSTEMI and a CTO.
Methods
Retrospective analysis of a six-centre percutaneous coronary intervention (PCI) registry in the UK between January 2015 and December 2020 was performed. Patients with a NSTEMI with and without a CTO were compared for baseline characteristics and outcomes.
Results
There were 17,355 NSTEMI patients in total of whom 1813 patients had a CTO (10.4 %). Patients with a CTO were more likely to be older (CTO: 67.8 (±11.5) years vs. no CTO: 67.2 (±12) years, p = 0.04), male (CTO: 81.1 % vs.71.9 %, p < 0.0001) with a greater prevalence of cardiovascular risk factors. All-cause mortality at 30 days: HR 2.63, 95 % CI 1.42–4.84, p = 0.002 and at 1 year: HR: 1.87, 95 % CI 1.25–2.81, p = 0.003 was higher in the CTO cohort. CTO patients who underwent revascularisation were younger (Revascularisation 66.4 [±11.7] years vs. no revascularisation 68.4 [±11.4] years, p = 0.001). Patients with failed CTO revascularisation had lower survival (HR 0.21, 95 % CI 0.10–0.42, p < 0.0001). The mean time to revascularisation was 13.4 days. There was variation in attempt at CTO revascularisation between the 6 centres for (16 % to 100 %) with success rates ranging from 65 to 100 %.
Conclusions
In conclusion, the presence of a CTO in NSTEMI patients undergoing PCI was associated with worse in-hospital and long-term outcomes.
Citation
Sharma, V., Choudhury, A., Basavarajaiah, S., Rashid, M., Yuan, M., Jefferey, D., …Mamas, M. A. (in press). Chronic total occlusion in non-ST elevation myocardial infarction - A multi-centre observational study. Cardiovascular Revascularization Medicine, 64, 62-67. https://doi.org/10.1016/j.carrev.2024.02.008
Journal Article Type | Article |
---|---|
Acceptance Date | Feb 12, 2024 |
Online Publication Date | Feb 14, 2024 |
Deposit Date | Mar 11, 2024 |
Journal | Cardiovascular revascularization medicine : including molecular interventions |
Print ISSN | 1553-8389 |
Electronic ISSN | 1878-0938 |
Publisher | Elsevier |
Peer Reviewed | Peer Reviewed |
Volume | 64 |
Pages | 62-67 |
DOI | https://doi.org/10.1016/j.carrev.2024.02.008 |
Keywords | Revascularisation, CTO, NSTEMI |
Public URL | https://keele-repository.worktribe.com/output/762924 |
Publisher URL | https://www.sciencedirect.com/science/article/pii/S1553838924000496?via%3Dihub |
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