Clinical cardiology
Mid-Term Clinical Outcomes According to CTO Revascularization Status in Patients With NSTEMI and Multivessel Disease
By Liu W, Li Y, Qin W and 4 others.
Abstract
Background
The clinical relevance of chronic total occlusion (CTO) revascularization in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease (MVD) remains uncertain.
Methods
In this multicenter retrospective cohort study, 632 patients with NSTEMI, MVD, and CTO were included. Patients were categorized into a complete revascularization group involving successful CTO recanalization (CR-CTO, n = 119) and an incomplete revascularization group without successful CTO recanalization (ICR-CTO, n = 513). The primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE) and major adverse cardiovascular events (MACE).
Results
During a mean follow-up of 528 ± 201 days, the incidences of MACCE (11.8% vs. 28.5%) and MACE (7.6% vs. 24.2%) were significantly lower in the CR-CTO group than in the ICR-CTO group (both p < 0.001). In multivariable Cox regression analyses, CR-CTO was independently associated with lower risks of MACCE (hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.20-0.61) and MACE (HR, 0.26; 95% CI, 0.13-0.51). Among patients without successful CTO recanalization, additional revascularization of non-CTO lesions was not associated with improved outcomes.