Abstract 17010: The Coronary Arteries Chronic Total Occlusion Recanalization Reduces Symptoms in Patients with Stabile Angina in Short- and Long-Term Observation
Objectives: Despite the ongoing technological progress and the introduction of more advanced equipment, chronic total occlusions (CTO) remains a challenge. Technical difficulties imply higher exposure to contrast media and radiation but clinical benefits of this procedure are not well defined. The goal of the study was to assess the influence of a successful recanalization of the coronary arteries chronic total occlusion on the reduction of angina symptoms and risk of major cardiovascular events (death, myocardial infarction, further revascularizations) in stable ischemic heart disease.
Methods: The study group consists of 401 patients (72.8% men), age 65.5±10.0 years, who underwent the PCI of the CTO in I Department of Cardiology, Medical University of Gdansk, Poland. We analyzed frequency of major adverse cardiac events (MACE) and CCS angina class in patients with successful procedure (group 1) and failure (group 2). The data from the 6-months and 18-months follow up was collected over the phone calls and clinical visits.
Results: There was significant difference in the prevalence of the angina symptoms between both groups in 6-month follow up (group 1 vs. group 2: 178 vs. 33, p<0.01) and 18-month observation (group 1 vs. group 2: 145 vs. 11, p<0.05). Moreover, the patients with ineffective recanalization of the CTO had to undergo the CABG much more often than the patients with effective recanalization in 6- and 18-months follow up (4.2% vs. 0,4%, p<0,01 and 9.1% vs. 1.2%, p<0,01, respectively). However there were no differences between the group 1 and group 2 in death, myocardial infarction and TVR or TLR frequency in 6-month follow up (respectively: 0 vs. 0; 2.3% vs. 1.4%; 13.6% vs.11.2%, all p=NS) and 18-month follow up (respectively: 1.9% vs. 2.1%; 3.9% vs. 2.8% and 23.6% vs. 14.7%, all p=NS).
Conclusions: Successful recanalization of the coronary arteries CTO considerably decrease angina intensity. The patients with the successful recanalization of the CTO had less frequent CABG. There is no influence of CTO recanalization results on the mortality, risk of myocardial infarction and new revascularizations during 6- and 18-month observation.
- © 2011 by American Heart Association, Inc.