Meta-analysis of the effect of percutaneous coronary intervention on chronic total coronary occlusions

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• 作者：Ruogu Li (1)
  Shuansuo Yang (2)
  Lei Tang (3)
  Yiqing Yang (4)
  Hui Chen (1)
  Shaofeng Guan (1)
  Wenzheng Han (1)
  Hua Liu (1)
  Jinjie Dai (1)
  Qian Gan (1)
  Weiyi Fang (1)
  Xinkai Qu (1)
  
• 关键词：Coronary artery chronic total occlusion ; Percutaneous coronary intervention ; Meta ; analysis
• 刊名：Journal of Cardiothoracic Surgery
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：9
• 期：1
• 全文大小：989 KB
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• 作者单位：Ruogu Li (1)
  Shuansuo Yang (2)
  Lei Tang (3)
  Yiqing Yang (4)
  Hui Chen (1)
  Shaofeng Guan (1)
  Wenzheng Han (1)
  Hua Liu (1)
  Jinjie Dai (1)
  Qian Gan (1)
  Weiyi Fang (1)
  Xinkai Qu (1)
  
  1. Department of Cardiology, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, NO.241, Huaihai Xi Road, Xuhui District, Shanghai, 200030, China
  2. Department of Cardiology, Central Hospital, Fengxian District, Shanghai, 201400, China
  3. School of Medical Graduate, Shanghai Jiaotong University, Shanghai, 200025, China
  4. Department of Cardiovascular Research, Shanghai Chest Hospital Affiliated to Shanghai Jiaotong University, Shanghai, 200030, China
  
• ISSN：1749-8090

文摘

Background and purpose Coronary chronic total occlusion (CTO) is the last stage of coronary artery atherosclerosis. Percutaneous coronary intervention (PCI) is a therapeutic procedure used to recanalize vessels with total occlusion. However, successful recanalization of CTO is still not optimal, and the key influence factors are still uncertainty. Therefore, a scientific evaluation on the effective of PCI for CTO treatment is necessary. Methods Relevant studies of PCI treatment for CTO were examined. Data were extracted and assessed by two independent clinical experts. Embase, PubMed and Medline et al. were used as database. The main research key words include “CTO- “PCI- “Stent- “Reopen- “long-term- “follow-up-and “outcome- Quality assessment was carried out according to the Cochrane Handbook. The selected data were pooled and analyzed using fixed-effect model and random-effect model. Heterogeneity was assessed using the I 2 test, Q test, L’abbe and Galbraith. Comprehensive Meta -Analysis 2.0 and Metanalysis 1.0 were used for statistics analysis in this research. Results A total of 16 articles involving 6695 cases in successful CTO recanalization (CTO success group) and 2370 cases in failed CTO recanalization(CTO failure group) were included in this research. Low CTO success was associated with elder age, previous coronary artery bypass graft surgery (CABG) history, multi-vessel diseases and right coronary artery disease lesion. Six follow-up variables including major adverse cardiac events (MACE), recurrent myocardial infarction (MI), all-cause death, incidence of angina, subsequent CABG and cumulative survival rate were found significantly reduced associated with CTO success. Conclusions Clinical baseline characteristics such as age, previous CABG history and lesion baseline characteristics such as lesion length, multi-vessel diseases might be important factors influencing the successful rate of CTO recanalization. Compared to CTO failure patients, all six follow-up variables showed advantage for CTO success patients.