Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 196-203 |
| Number of pages | 8 |
| Journal | Heart |
| Volume | 105 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jul 30 2018 |
Keywords
- cardiac computer tomographic (ct) imaging
- heart disease
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Prognostic value of chronic total occlusions detected on coronary computed tomographic angiography. / Opolski, M.P.; Gransar, H.; Lu, Y.; Achenbach, S.; Al-Mallah, M.H.; Andreini, D.; Bax, J.J.; Berman, D.S.; Budoff, M.J.; Cademartiri, F.; Callister, T.Q.; Chang, H.-J.; Chinnaiyan, K.; Chow, B.J.W.; Cury, R.C.; DeLago, A.; Feuchtner, G.M.; Hadamitzky, M.; Hausleiter, J.; Kaufmann, P.A.; Kim, Y.-J.; Leipsic, J.A.; Maffei, E.C.; Marques, H.; Pontone, G.; Raff, G.; Rubinshtein, R.; Shaw, L.J.; Villines, T.C.; Gomez, M.; Jones, E.C.; Peña, J.M.; Min, J.K.; Lin, F.Y.
In: Heart, Vol. 105, No. 3, 30.07.2018, p. 196-203.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Prognostic value of chronic total occlusions detected on coronary computed tomographic angiography
AU - Opolski, M.P.
AU - Gransar, H.
AU - Lu, Y.
AU - Achenbach, S.
AU - Al-Mallah, M.H.
AU - Andreini, D.
AU - Bax, J.J.
AU - Berman, D.S.
AU - Budoff, M.J.
AU - Cademartiri, F.
AU - Callister, T.Q.
AU - Chang, H.-J.
AU - Chinnaiyan, K.
AU - Chow, B.J.W.
AU - Cury, R.C.
AU - DeLago, A.
AU - Feuchtner, G.M.
AU - Hadamitzky, M.
AU - Hausleiter, J.
AU - Kaufmann, P.A.
AU - Kim, Y.-J.
AU - Leipsic, J.A.
AU - Maffei, E.C.
AU - Marques, H.
AU - Pontone, G.
AU - Raff, G.
AU - Rubinshtein, R.
AU - Shaw, L.J.
AU - Villines, T.C.
AU - Gomez, M.
AU - Jones, E.C.
AU - Peña, J.M.
AU - Min, J.K.
AU - Lin, F.Y.
N1 - Cited By :2 Export Date: 24 January 2019 CODEN: HEARF Correspondence Address: Min, J.K.; Dalio Institute of Cardiovacular Imaging, New York-Presbyterian Hospital, Weill Cornell Medicine, 413 East 69th Street, United States; email: jkm2001@med.cornell.edu References: Fefer, P., Knudtson, M.L., Cheema, A.N., Current perspectives on coronary chronic total occlusions: The Canadian multicenter chronic total occlusions registry (2012) J Am Coll Cardiol, 59, pp. 991-997; Christakopoulos, G.E., Christopoulos, G., Carlino, M., Meta-analysis of clinical outcomes of patients who underwent percutaneous coronary interventions for chronic total occlusions (2015) Am J Cardiol, 115, pp. 1367-1375; O'Connor, S.A., Garot, P., Sanguineti, F., Meta-Analysis of the impact on mortality of noninfarct-related artery coronary chronic total occlusion in patients presenting with ST-Segment elevation myocardial infarction (2015) Am J Cardiol, 116, pp. 8-14; Budoff, M.J., Dowe, D., Jollis, J.G., Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: Results from the prospective multicenter ACC URAC y (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial (2008) J Am Coll Cardiol, 52, pp. 1724-1732; Hadamitzky, M., Achenbach, S., Al-Mallah, M., Optimized prognostic score for coronary computed tomographic angiography: Results from the CONFIRM registry (Coronary CT Angiography evaluation for clinical outcomes: An International Multicenter Registry) (2013) J Am Coll Cardiol, 62, pp. 468-476; Opolski, M.P., Achenbach, S., Schuhback, A., Coronary computed tomographic prediction rule for time-efficient guidewire crossing through chronic total occlusion: Insights from the CT-RECTOR multicenter registry (Computed Tomography Registry of Chronic Total Occlusion Revascularization) (2015) JACC Cardiovasc Interv, 8, pp. 257-267; Opolski, M.P., Achenbach, S., CT Angiography for revascularization of CTO: Crossing the borders of diagnosis and treatment (2015) JACC Cardiovasc Imaging, 8, pp. 846-858; Opolski, M.P., O'Hartaigh, B., Berman, D.S., Current trends in patients with chronic total occlusions undergoing coronary CT angiography (2015) Heart, 101, pp. 1212-1218; Min, J.K., Dunning, A., Lin, F.Y., Rationale and design of the CONFIRM (COronary CT Angiography Evaluation for Clinical Outcomes: An international multicenter) Registry (2011) J Cardiovasc Comput Tomogr, 5, pp. 84-92; Min, J.K., Shaw, L.J., Devereux, R.B., Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality (2007) J Am Coll Cardiol, 50, pp. 1161-1170; Diamond, G.A., Forrester, J.S., Hirsch, M., Application of conditional probability analysis to the clinical diagnosis of coronary artery disease (1980) J Clin Invest, 65, pp. 1210-1221; Abidov, A., Rozanski, A., Hachamovitch, R., Prognostic significance of dyspnea in patients referred for cardiac stress testing (2005) N Engl J Med, 353, pp. 1889-1898; Abbara, S., Blanke, P., Maroules, C.D., SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI) (2016) J Cardiovasc Comput Tomogr, 10, pp. 435-449; Austen, W.G., Edwards, J.E., Frye, R.L., A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc committee for grading of coronary artery disease, council on cardiovascular surgery, American Heart Association (1975) Circulation, 51, pp. 5-40; George, S., Cockburn, J., Clayton, T.C., Long-term follow-up of elective chronic total coronary occlusion angioplasty: Analysis from the U.K. Central Cardiac Audit Database (2014) J Am Coll Cardiol, 64, pp. 235-243; Tomasello, S.D., Boukhris, M., Giubilato, S., Management strategies in patients affected by chronic total occlusions: Results from the Italian Registry of Chronic Total Occlusions (2015) Eur Heart J, 36, pp. 3189-3198; Khan, M.F., Wendel, C.S., Thai, H.M., Effects of percutaneous revascularization of chronic total occlusions on clinical outcomes: A meta-analysis comparing successful versus failed percutaneous intervention for chronic total occlusion (2013) Catheter Cardiovasc Interv, 82, pp. 95-107; Hannan, E.L., Zhong, Y., Jacobs, A.K., Patients with chronic total occlusions undergoing percutaneous coronary interventions: Characteristics, success, and outcomes (2016) Circ Cardiovasc Interv, 9, p. e003586; Ramunddal, T., Hoebers, L.P., Henriques, J.P., Prognostic impact of chronic total occlusions: A report from SCAAR (Swedish Coronary Angiography and Angioplasty Registry) (2016) JACC Cardiovasc Interv, 9, pp. 1535-1544; Tajstra, M., Pyka, L., Gorol, J., Impact of chronic total occlusion of the coronary artery on long-term prognosis in patients with ischemic systolic heart failure: Insights from the COMMIT-HF registry (2016) JACC Cardiovasc Interv, 9, pp. 1790-1797; Mock, M.B., Ringqvist, I., Fisher, L.D., Survival of medically treated patients in the coronary artery surgery study (CASS) registry (1982) Circulation, 66, pp. 562-568; Lee, P.H., Lee, S.W., Park, H.S., Successful recanalization of native coronary chronic total occlusion is not associated with improved long-term survival (2016) JACC Cardiovasc Interv, 9, pp. 530-538; Tsai, T.T., Stanislawski, M.A., Shunk, K.A., Contemporary incidence, management, and long-term outcomes of percutaneous coronary interventions for chronic coronary artery total occlusions: Insights from the VA CART Program (2017) JACC Cardiovasc Interv, 10, pp. 866-875
PY - 2018/7/30
Y1 - 2018/7/30
N2 - Objective: Data describing clinical relevance of chronic total occlusion (CTO) identified by coronary CT angiography (CCTA) have not been reported to date. We investigated the prognosis of CTO on CCTA. Methods: We identified 22 828 patients without prior known coronary artery disease (CAD), who were followed for a median of 26 months. Based on CCTA, coronary lesions were graded as normal (no atherosclerosis), non-obstructive (1%-49%), moderate-to-severe (50%-99%) or totally occluded (100%). All-cause mortality, and major adverse cardiac events defined as mortality, non-fatal myocardial infarction and late coronary revascularisation (≥90 days after CCTA) were assessed. Results: The distribution of patients with normal coronaries, non-obstructive CAD, moderate-to-severe CAD and CTO was 10 034 (44%), 7965 (34.9%), 4598 (20.1%) and 231 (1%), respectively. The mortality rate per 1000 person-years of CTO patients was non-significantly different from patients with moderate-to-severe CAD (22.95; 95% CI 12.71 to 41.45 vs 14.46; 95% CI 12.34 to 16.94; p=0.163), and significantly higher than of those with normal coronaries and non-obstructive CAD (p
AB - Objective: Data describing clinical relevance of chronic total occlusion (CTO) identified by coronary CT angiography (CCTA) have not been reported to date. We investigated the prognosis of CTO on CCTA. Methods: We identified 22 828 patients without prior known coronary artery disease (CAD), who were followed for a median of 26 months. Based on CCTA, coronary lesions were graded as normal (no atherosclerosis), non-obstructive (1%-49%), moderate-to-severe (50%-99%) or totally occluded (100%). All-cause mortality, and major adverse cardiac events defined as mortality, non-fatal myocardial infarction and late coronary revascularisation (≥90 days after CCTA) were assessed. Results: The distribution of patients with normal coronaries, non-obstructive CAD, moderate-to-severe CAD and CTO was 10 034 (44%), 7965 (34.9%), 4598 (20.1%) and 231 (1%), respectively. The mortality rate per 1000 person-years of CTO patients was non-significantly different from patients with moderate-to-severe CAD (22.95; 95% CI 12.71 to 41.45 vs 14.46; 95% CI 12.34 to 16.94; p=0.163), and significantly higher than of those with normal coronaries and non-obstructive CAD (p
KW - cardiac computer tomographic (ct) imaging
KW - heart disease
U2 - 10.1136/heartjnl-2017-312907
DO - 10.1136/heartjnl-2017-312907
M3 - Article
VL - 105
SP - 196
EP - 203
JO - Heart
JF - Heart
SN - 1355-6037
IS - 3
ER -