Observational studyCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2025
Myocardial Infarction and All-Cause Mortality Following Percutaneous Coronary Intervention Versus Conservative Treatment of Chronic Total Occlusions: A West Denmark Heart Registry Study.
Observational study in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Myocardial Viability and Ischaemia in Chronic Total Occlusion.Medicina (Kaunas, Lithuania) · 2026Article
- Impact of myocardial perfusion abnormalities on clinical outcomes in patients treated with percutaneous coronary intervention for chronic total occlusions.European heart journal. Imaging methods and practice · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundChronic coronary total occlusions (CTO) represent a therapeutic challenge, and results of randomized clinical trials and observational studies comparing conservative treatment versus percutaneous coronary intervention (PCI) are underpowered.
aimsTo assess myocardial infarction (MI) and all-cause mortality in consecutive patients with CTO lesions.
methodsUsing data from the West Denmark Heart Registry, patients with chronic coronary syndrome and a 100% occluded vessel by invasive coronary angiography (ICA) were identified. Patients were stratified according to PCI within 90 days. Five-year risk of MI and all-cause mortality was calculated using cause-specific Cox-models and g-formula methods. Subsequently, models were stratified on sex, diabetes, estimated glomerular filtration rate above 60 mL/min, procedure before 2012, and history of cardiac surgery. The risk was calculated for patients who did not experience MI or death within 30 days of the initial ICA.
resultsA total of 7675 patients were included in the study, of whom 3129 patients underwent PCI, and 4546 patients were treated conservatively. PCI- and conservatively treated patients had comparable risks of MI (13.1% [95% confidence interval [CI] 12.0%-14.3%] for patients who underwent PCI vs. 13.4% [95% CI 12.4%-13.4%] for patients who received conservative treatment). For all-cause mortality, results were 14.4% (95% CI 13.3%-15.5%) versus 18.9% (95% CI 17.8%-20.0%), respectively. Results were consistent across subgroups. However, CTO-PCI-treated patients with previous heart surgery were at higher risk of MI.
conclusionsPatients who underwent CTO-PCI had a comparable 5-year risk of MI and lower all-cause mortality as compared to conservatively treated patients.
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