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
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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 -