TY - JOUR
T1 - Periprocedural Mortality in Chronic Total Occlusion Percutaneous Coronary Intervention
T2 - Insights from the PROGRESS-CTO Registry
AU - Simsek, Bahadir
AU - Rempakos, Athanasios
AU - Kostantinis, Spyridon
AU - Karacsonyi, Judit
AU - Gorgulu, Sevket
AU - Alaswad, Khaldoon
AU - Choi, James W.
AU - Jaffer, Farouc A.
AU - Doshi, Darshan
AU - Poommipanit, Paul
AU - Aygul, Nazif
AU - Krestyaninov, Oleg
AU - Khelimskii, Dmitrii
AU - Uretsky, Barry
AU - Davies, Rhian
AU - Goktekin, Omer
AU - Elguindy, Ahmed
AU - Jefferson, Brian K.
AU - Patel, Taral N.
AU - Patel, Mitul
AU - Sheikh, Abdul
AU - Karmpaliotis, Dimitri
AU - Potluri, Srinivasa
AU - Al-Azizi, Karim
AU - Mastrodemos, Olga C.
AU - Rangan, Bavana V.
AU - Allana, Salman S.
AU - Sandoval, Yader
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Background: Death is a rare but devastating complication of chronic total occlusion (CTO) percutaneous coronary intervention. Methods: We examined the clinical characteristics and procedural outcomes of patients who died periprocedurally in the Prospective Global Registry for the Study of CTO Interventions (PROGRESS-CTO). Results: Of the 12 928 patients who underwent CTO percutaneous coronary intervention between 2012 and 2022, 52 (0.4%) died during the index hospitalization. Patients who died were more likely to have a history of heart failure (43% versus 28%; P=0.023). The J-CTO ([Multicenter CTO Registry of Japan]; 2.8±1.1 versus 2.4±1.3; P=0.019), PROGRESS-CTO mortality (2.6±0.9 versus 1.6±1.1; P<0.001), and PROGRESS-CTO pericardiocentesis (2.9±1.1 versus 1.9±1.3; P<0.001) scores were higher in patients who died. In these patients, the use of left ventricular assist devices was also higher (41% versus 3.5%; P<0.001), and retrograde crossing was more often the first crossing strategy (33% versus 13%; P<0.001). The cause of death was cardiac in 43 patients (83%) and noncardiac in 9 patients (17%). Complications leading to cardiac death were: tamponade in 30 patients (58%), acute myocardial infarction in 9 (17.3%), and cardiac arrest/shock in 4 (7.7%). Noncardiac causes of death were: stroke in 3 (5.8%), renal failure in 2 (3.8%), respiratory distress in 2 (3.8%), and hemorrhagic shock in 2 (3.8%). Conclusions: Approximately 0.4% of patients who underwent CTO percutaneous coronary intervention died during the index hospitalization. The main cause of death was tamponade in 58%. PROGRESS-CTO complication scores might help in risk stratification and procedural planning in patients undergoing CTO percutaneous coronary intervention. Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02061436.
AB - Background: Death is a rare but devastating complication of chronic total occlusion (CTO) percutaneous coronary intervention. Methods: We examined the clinical characteristics and procedural outcomes of patients who died periprocedurally in the Prospective Global Registry for the Study of CTO Interventions (PROGRESS-CTO). Results: Of the 12 928 patients who underwent CTO percutaneous coronary intervention between 2012 and 2022, 52 (0.4%) died during the index hospitalization. Patients who died were more likely to have a history of heart failure (43% versus 28%; P=0.023). The J-CTO ([Multicenter CTO Registry of Japan]; 2.8±1.1 versus 2.4±1.3; P=0.019), PROGRESS-CTO mortality (2.6±0.9 versus 1.6±1.1; P<0.001), and PROGRESS-CTO pericardiocentesis (2.9±1.1 versus 1.9±1.3; P<0.001) scores were higher in patients who died. In these patients, the use of left ventricular assist devices was also higher (41% versus 3.5%; P<0.001), and retrograde crossing was more often the first crossing strategy (33% versus 13%; P<0.001). The cause of death was cardiac in 43 patients (83%) and noncardiac in 9 patients (17%). Complications leading to cardiac death were: tamponade in 30 patients (58%), acute myocardial infarction in 9 (17.3%), and cardiac arrest/shock in 4 (7.7%). Noncardiac causes of death were: stroke in 3 (5.8%), renal failure in 2 (3.8%), respiratory distress in 2 (3.8%), and hemorrhagic shock in 2 (3.8%). Conclusions: Approximately 0.4% of patients who underwent CTO percutaneous coronary intervention died during the index hospitalization. The main cause of death was tamponade in 58%. PROGRESS-CTO complication scores might help in risk stratification and procedural planning in patients undergoing CTO percutaneous coronary intervention. Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02061436.
KW - cause of death
KW - death
KW - mortality
KW - percutaneous coronary intervention
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U2 - 10.1161/CIRCINTERVENTIONS.123.012977
DO - 10.1161/CIRCINTERVENTIONS.123.012977
M3 - Article
C2 - 37259859
AN - SCOPUS:85163398362
SN - 1941-7640
VL - 16
SP - E012977
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
IS - 6
ER -