| Autor: |
Bahadir, Simsek, Spyridon, Kostantinis, Judit, Karacsonyi, Khaldoon, Alaswad, Michael, Megaly, Dimitrios, Karmpaliotis, Amirali, Masoumi, Wissam A, Jaber, William, Nicholson, Stephane, Rinfret, Kambis, Mashayekhi, Gerald S, Werner, Margaret, McEntegart, Seung-Whan, Lee, Jaikirshan J, Khatri, Scott A, Harding, Alexandre, Avran, Farouc A, Jaffer, Darshan, Doshi, Hsien-Li, Kao, Georgios, Sianos, Masahisa, Yamane, Anastasios, Milkas, Lorenzo, Azzalini, Roberto, Garbo, Khalid, Tammam, Nidal, Abi Rafeh, Ilias, Nikolakopoulos, Evangelia, Vemmou, Bavana V, Rangan, M Nicholas, Burke, Santiago, Garcia, Kevin J, Croce, Eugene B, Wu, Etsuo, Tsuchikane, Carlo, Di Mario, Alfredo R, Galassi, Andrea, Gagnor, Paul, Knaapen, Yangsoo, Jang, Byeong-Keuk, Kim, Paul B, Poommipanit, Emmanouil S, Brilakis |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
The Journal of invasive cardiology. 34(11) |
| ISSN: |
1557-2501 |
| Popis: |
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) can improve patient symptoms, but it remains controversial whether it impacts subsequent clinical outcomes.In this systematic review and meta-analysis, we queried PubMed, ScienceDirect, Cochrane Library, Web of Science, and Embase databases (last search: September 15, 2021). We investigated the impact of CTO-PCI on clinical events including all-cause mortality, cardiovascular death, myocardial infarction (MI), major adverse cardiovascular event (MACE), stroke, subsequent coronary artery bypass surgery, target-vessel revascularization, and heart failure hospitalizations. Pooled analysis was performed using a random-effects model.A total of 58 publications with 54,540 patients were included in this analysis, of which 33 were observational studies of successful vs failed CTO-PCI, 19 were observational studies of CTO-PCI vs no CTO-PCI, and 6 were randomized controlled trials (RCTs). In observational studies, but not RCTs, CTO-PCI was associated with better clinical outcomes. Odds ratios (ORs) and 95% confidence intervals (CIs) for all-cause mortality, MACE, and MI were 0.52 (95% CI, 0.42-0.64), 0.46 (95% CI, 0.37-0.58), 0.66 (95% CI, 0.50-0.86), respectively for successful vs failed CTO-PCI studies; 0.38 (95% CI, 0.31-0.45), 0.57 (95% CI, 0.42-0.78), 0.65 (95% CI, 0.42-0.99), respectively, for observational studies of CTO-PCI vs no CTO-PCI; 0.72 (95% CI, 0.39-1.32), 0.69 (95% CI, 0.38-1.25), and 1.04 (95% CI, 0.46-2.37), respectively for RCTs.CTO-PCI is associated with better subsequent clinical outcomes in observational studies but not in RCTs. Appropriately powered RCTs are needed to conclusively determine the impact of CTO-PCI on clinical outcomes. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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