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|Title:||Health Status Benefits of Successful Chronic Total Occlusion Revascularization Across the Spectrum of Left Ventricular Function: Insights From the OPEN-CTO Registry|
|Authors:||Khariton, Yevgeniy;Airhart, Sophia;Salisbury, Adam C.;Spertus, John a.;Gosch, Kensey L.;Grantham, J. Aaron;Karmpaliotis, Dimitrios;Moses, Jeffrey W.;Nicholson, William J.;Cohen, David J.;Lombardi, William;Sapontis, James;McCabe, James M.|
|Keywords:||cardiomyopathy;chronic total occlusion;health status|
|Abstract:||Objectives: This study sought to describe the association between chronic total occlusion (CTO) revascularization (CTO percutaneous coronary intervention [PCI]) and health status in patients with and without cardiomyopathy. Background: Prior PCI trials for cardiomyopathy have excluded CTO patients. Whether patients with reduced left ventricular ejection fraction (LVEF) receive similar health status benefit from CTO-PCI compared with patients with normal LVEF is unclear. Methods: We assessed health status change, using the Seattle Angina Questionnaire (SAQ) Summary, SAQ Angina Frequency, and Rose Dyspnea Scale scores, among patients undergoing successful CTO PCI in the OPEN-CTO (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion) Registry. Participants were classified by LVEF (normal, ≥50%; mild-moderate, 30% to 49%; and severe, <30%), with higher SAQ and lower Rose Dyspnea Scale scores indicating better health status. Differences in 1-year outcomes were compared using hierarchical multivariable regression. Results: Of 762 patients, 506 (66.4%), 193 (25.3%), and 63 (8.3%) had normal, mild-moderate, and severely reduced LVEF. SAQ Summary score improvements were observed in each group (27.1 ± 20.4, 26.7 ± 21.2, and 20.3 ± 18.1, respectively). Compared with patients with LVEF ≥50%, those with LVEF <30% had less improvement in SAQ Summary Score (−5.2 points; 95% confidence interval: −9.0 to −1.5; p = 0.01) and Rose Dyspnea Scale (+0.5 points; 95% confidence interval: 0.1 to 0.8; p = 0.01), with no difference in odds of angina (odds ratio: 1.3; 95% confidence interval: 0.6 to 3.0; p = 0.48). Health status improvement was similar between patients with LVEF ≥50% and LVEF 30% to 49%. Conclusions: Although health status improvement was less in patients with severely reduced LVEF compared with those with normal LVEF, each group experienced large health status improvements after CTO-PCI.|
|More Information:||VOLUME : 11 ISSUE : 22 START PAGE : 2276 END PAGES : 2283|
|Appears in Collections:||JACC Cardiovascular Interventions|
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|2018 JACCinterventions Volume 11 Issue 22 November (12).pdf||577.92 kB||Adobe PDF|
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