The impact of right coronary artery chronic total occlusion on clinical outcome of patients undergoing percutaneous coronary intervention for unprotected left main disease.
In: Journal of the American College of Cardiology, Jg. 58 (2011-07-05), Heft 2, S. 125-30
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Zugriff:
Objectives: The aim of the present study was to investigate whether right coronary artery chronic total occlusion (CTO) carries prognostic implications in patients undergoing drug-eluting stent-supported percutaneous coronary intervention (PCI) for unprotected left main disease (ULMD).
Background: No data exist on the prognostic implication of CTO in patients undergoing PCI for ULMD.
Methods: Prospective registry of consecutive patients undergoing PCI for ULMD. Patients with ST-segment elevation myocardial infarction were excluded. Primary endpoints were 6-month and long-term cardiac mortality.
Results: From January 2004 to December 2009, 330 patients underwent PCI for ULMD. Of the 330 patients, 78 (24%) had CTO of the right coronary artery, 22 (7%) had CTO of the left anterior descending artery, and 16 (5%) had CTO of the left circumflex artery. Patients with right coronary artery CTO had a higher risk profile compared with patients without right coronary artery CTO. The 6-month mortality rate was 12.8% in patients with right coronary artery CTO, and 3.6% in patients without right coronary artery CTO (p < 0.002), and the 3-year cardiac survival rate was 76.4 ± 6.8% and 89.7 ± 2.7% (p < 0.003), respectively. By multivariable analysis, the only 2 independent predictors of 3-year cardiac mortality were right coronary artery CTO (hazard ratio: 2.15, 95% confidence interval: 1.02 to 4.50; p = 0.043) and EuroSCORE (hazard ratio: 1.03, 95% confidence interval: 1.02 to 1.05; p < 0.001).
Conclusions: Right coronary artery CTO occurs frequently and is a significant predictor of mortality in patients with ULMD undergoing PCI.
(Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Titel: |
The impact of right coronary artery chronic total occlusion on clinical outcome of patients undergoing percutaneous coronary intervention for unprotected left main disease.
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Autor/in / Beteiligte Person: | Migliorini, A ; Valenti, R ; Parodi, G ; Buonamici, P ; Cerisano, G ; Carrabba, N ; Vergara, R ; Antoniucci, D |
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Zeitschrift: | Journal of the American College of Cardiology, Jg. 58 (2011-07-05), Heft 2, S. 125-30 |
Veröffentlichung: | [New York, N.Y.] : Elsevier Biomedical, [c1983-, 2011 |
Medientyp: | academicJournal |
ISSN: | 1558-3597 (electronic) |
DOI: | 10.1016/j.jacc.2011.02.050 |
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