Background
Methods
Study design and population
Definitions of variables and clinical endpoints
Data collection and follow-up
Statistical analysis
CTO-MT (n = 443) | CTO-SR (n = 500) | P value | |
---|---|---|---|
Clinical characteristics | |||
Age (years) | 60.65 ± 10.58 | 59.97 ± 8.78 | 0.285 |
Male | 322 (72.7) | 392 (78.4) |
0.041
|
Hypertension | 308 (69.5) | 337 (67.4) | 0.483 |
Dyslipidemia | 152 (34.3) | 139 (27.8) |
0.031
|
PVD | 18 (4.1) | 15 (3.0) | 0.375 |
Prior MI | 234 (52.8) | 285 (57.0) | 0.198 |
Prior PCI | 90 (20.3) | 72 (14.4) |
0.016
|
Prior stroke | 35 (7.9) | 22 (4.4) |
0.024
|
Heart failure | 125 (28.2) | 149 (29.8) | 0.593 |
Systolic heart failure | 52 (11.7) | 63 (12.6) | 0.686 |
Diastolic heart failure | 73 (16.5) | 86 (17.2) | 0.768 |
CKD | 15 (3.4) | 10 (2.0) | 0.186 |
COPD/asthma | 4 (0.9) | 4 (0.8) | 0.864 |
Hyperuricemia | 97 (21.9) | 86 (17.2) |
0.069
|
Smoking | 216 (48.8) | 266 (53.2) | 0.173 |
Drinking | 74 (16.7) | 91 (18.2) | 0.546 |
BMI (kg/m2) | 26.46 ± 3.31 | 26.67 ± 3.02 | 0.304 |
LVEF (%) | 61.00 (55.00–66.50) | 60.00 (55.00–66.00) | 0.153 |
RWMA | 144 (32.5) | 160 (32.0) | 0.868 |
Fasting blood glucose(mmol/L) | 7.20 (6.25–9.31) | 7.41 (6.13–9.26) | 0.727 |
HbA1c (%)b | 7.3 (6.7–8.0) | 7.3 (6.9–7.9) | 0.753 |
Medical treatment | |||
Aspirin | 428 (96.8) | 429 (98.4) | 0.114 |
P2Y12 inhibitor | 396 (89.6) | 410 (82.3) |
0.001
|
Statin | 422 (95.5) | 462 (92.8) | 0.080 |
Nitrites | 262 (59.3) | 152 (30.5) |
0.000
|
Beta-blocker | 341 (77.1) | 405 (81.3) | 0.114 |
CCB | 123 (27.8) | 123 (24.7) | 0.276 |
ACEI/ARB | 246 (55.7) | 272 (54.6) | 0.750 |
Insulin | 160 (36.1) | 202 (40.4) | 0.177 |
Sulfonylureas | 64 (14.4) | 66 (13.2) | 0.579 |
Glinide | 20 (4.5) | 18 (3.6) | 0.476 |
Biguanides | 152 (34.3) | 195 (39.0) | 0.136 |
Thiazolidinediones | 48 (10.8) | 54 (10.8) | 0.986 |
Alpha-glucosidase inhibitor | 159 (35.9) | 151 (30.2) | 0.063 |
Angiographic characteristics | |||
Dominance artery (right) | 396 (89.4) | 488 (97.6) |
0.000
|
Number of diseased vessels | |||
1 | 115 (26.0) | 94 (18.8) |
0.008
|
2 | 151 (34.1) | 201 (40.2) | 0.053 |
3 | 177 (40.0) | 205 (41.0) | 0.744 |
Syntax scorea | 20.00 (13.00–27.00) | 20.00 (17.00–23.00) | 0.400 |
Rentrop grade ≥ 2a | 309 (82.4) | 368 (88.0) |
0.025
|
Abrupt stumpa | 188 (50.1) | 205 (49.0) | 0.759 |
Calcificationa | 73 (19.5) | 80 (19.1) | 0.907 |
Bending ≥ 45°a | 327 (87.2) | 361 (86.4) | 0.729 |
CTO length ≥ 20 mma | 278 (74.1) | 308 (73.7) | 0.886 |
Procedural characteristics | |||
Retrograde approachc | 3 (1.6) | 41 (13.3) |
0.000
|
Perforationc | 4 (0.9) | 1 (0.2) | 0.193 |
Pericardial effusionc | 0 (0) | 0 (0) | – |
Emergency surgeryc | 0 (0) | 0 (0) | – |
Contrast retention/dissectionc | 2 (0.5) | 5 (1.0) | 0.457 |
Thread offc | 1 (0.2) | 0 (0) | 0.470 |
Sudden cardiac arrestc | 0 (0) | 1 (0.2) | 1.000 |
Death during hospitalizationc | 1 (0.2) | 3 (0.6) | 0.627 |
Results
Baseline characteristics (total population)
Clinical outcomes
CTO-MT | CTO-SR | P value | |
---|---|---|---|
All cause death | |||
Event per 1000 patient-years | 28.05 | 12.17 |
0.000
|
Unadjusted HR (95% CI) | 1 | 0.423 (0.270–0.663) |
0.000
|
Adjusted HR (95% CI) Model 1 | 1 | 0.429 (0.269–0.682) |
0.000
|
Adjusted HR (95% CI) Model 2 | 1 | 0.445 (0.278–0.714) |
0.001
|
Noncardiac death | |||
Event per 1000 patient-years | 5.82 | 5.28 | 0.808 |
Unadjusted HR (95% CI) | 1 | 0.829 (0.370–1.860) | 0.649 |
Adjusted HR (95% CI) Model 1 | 1 | 1.351 (0.538–3.392) | 0.522 |
Adjusted HR (95% CI) Model 2 | 1 | 1.778 (0.684–4.618) | 0.237 |
Cardiac death | |||
Event per 1000 patient-years | 22.23 | 6.90 |
0.000
|
Unadjusted HR (95% CI) | 1 | 0.311 (0.177–0.547) |
0.000
|
Adjusted HR (95% CI) Model 1 | 1 | 0.308 (0.172–0.550) |
0.000
|
Adjusted HR (95% CI) Model 2 | 1 | 0.307 (0.169–0.557) |
0.000
|
Probable/definite cardiac death | |||
Event per 1000 patient-years | 12.17 | 3.65 |
0.000
|
Unadjusted HR (95% CI) | 1 | 0.297 (0.137–0.644) |
0.002
|
Adjusted HR (95% CI) Model 1 | 1 | 0.309 (0.138–0.693) |
0.004
|
Adjusted HR (95% CI) Model 2 | 1 | 0.341 (0.151–0.771) |
0.010
|
Repeat nonfatal MI | |||
Event per 1000 patient-years | 13.58 | 7.00 |
0.031
|
Unadjusted HR (95% CI) | 1 | 0.493 (0.266–0.915) |
0.025
|
Adjusted HR (95% CI) Model 1 | 1 | 0.466 (0.245–0.888) |
0.020
|
Adjusted HR (95% CI) Model 2 | 1 | 0.513 (0.264–0.998) |
0.049
|
Repeat revascularization | |||
Event per 1000 patient-years | 56.95 | 37.86 |
0.005
|
Unadjusted HR (95% CI) | 1 | 0.683 (0.509–0.915) |
0.011
|
Adjusted HR (95% CI) Model 1 | 1 | 0.689 (0.512–0.928) |
0.014
|
Adjusted HR (95% CI) Model 2 | 1 | 0.702 (0.516–0.955) |
0.024
|
TVR | |||
Event per 1000 patient-years | 36.13 | 20.48 |
0.002
|
Unadjusted HR (95% CI) | 1 | 0.591 (0.406–0.862) |
0.006
|
Adjusted HR (95% CI) Model 1 | 1 | 0.587 (0.401–0.858) |
0.006
|
Adjusted HR (95% CI) Model 2 | 1 | 0.613 (0.413–0.909) |
0.015
|
Propensity score matched analysis
CTO-MT | CTO-SR | P value | |
---|---|---|---|
All cause death | |||
Event per 1000 patient-years | 30.15 | 15.03 |
0.010
|
HR (95% CI) | 1 | 0.502 (0.291–0.865) |
0.013
|
Non-cardiac death | |||
Event per 1000 patient-years | 7.34 | 7.52 | 0.957 |
HR (95% CI) | 1 | 1.038 (0.422–2.555) | 0.936 |
Cardiac death | |||
Event per 1000 patient-years | 22.82 | 7.52 |
0.001
|
HR (95% CI) | 1 | 0.331 (0.161–0.681) |
0.003
|
Probable/definite cardiac death | |||
Event per 1000 patient-years | 11.41 | 6.01 | 0.140 |
HR (95% CI) | 1 | 0.524 (0.220–1.250) | 0.145 |
Repeat nonfatal MI | |||
Event per 1000 patient-years | 15.95 | 9.16 | 0.126 |
HR (95% CI) | 1 | 0.571 (0.277–1.177) | 0.129 |
Repeat revascularization | |||
Event per 1000 patient-years | 61.79 | 39.08 |
0.012
|
HR (95% CI) | 1 | 0.639 (0.440–0.927) |
0.018
|
TVR | |||
Event per 1000 patient-years | 37.70 | 21.45 |
0.018
|
HR (95% CI) | 1 | 0.574 (0.355–0.930) |
0.024
|