Seven-Year Clinical Outcomes of Successful Versus Failed Revascularization Using Drug-Eluting Stents for the Treatment of Coronary Chronic Total Occlusion

Abstract

Objectives. The aim of our study is to investigate the long-term, 7-year clinical outcomes of patients who received successful or failed revascularization using a drug-eluting stent (DES) for the treatment of chronic total occlusion (CTO). Background. The benefits of successful CTO revascularization remain unclear. Methods. In this prospective cohort study, a total of 377 consecutive CTO patients were divided according to successful (n = 253) or failed (n = 124) DES revascularization. We compared a composite index that consisted of death, myocardial infarction (MI), stroke, and target-vessel revascularization (TVR) at 7 years using propensity matching and inverse probability of treatment weighted (IPTW) analyses. Results. After a median follow-up period of 2561 days (interquartile range, 1533-2996 days), the successful-revascularization group demonstrated numerically lower incidence of the composite endpoint than the failed-revascularization group (26.5% vs 34.3%, respectively; log-rank P=. 27). After IPTW adjustment, the risk of clinical outcomes (hazard ratio, 1.00; 95% confidence interval, 0.58-1.74; P=. 99) was not statistically different between the groups. Propensity-score matching analysis (91 matched pairs) revealed similar outcomes (hazard ratio, 1.09; 95% confidence interval, 0.62-1.90; P=. 77). Conclusions. Successful CTO revascularization does not demonstrate beneficial long-term clinical outcomes over 7 years compared with failed revascularization.