Evidence map›Paper›PMID 39985700›Full record

ArticleHeart and vessels2025

Retrograde percutaneous coronary intervention for chronic total occlusions in patients with reduced left ventricular ejection fraction: a single-center retrospective cohort study.

Song Wen, Chang Dai, Zehan Huang, Jing Wang, Feng Wang, Kaize Wu, Dunliang Ma, Feihuang Han, Jiquan Xiao, Yuqing Huang and 2 more

Abstract read
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Article in Heart and vessels, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Song Wen *Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Chang Dai *Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Zehan Huang *Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Jing WangDepartment of Cardiology, Shenzhen Luohu Hospital Group Luohu People's Hospital, The Third Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong, China.
Feng WangDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Kaize WuDepartment of Cardiology, School of Medicine, The Sixth Affiliated Hospital, South China University of Technology, Guangzhou, 528000, Guangdong, China.
Dunliang MaDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Feihuang HanDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Jiquan XiaoDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China.
Yuqing HuangDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China. huangyuqing@gdph.org.cn.
Shulin WuDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China. doctorwushulin@163.com.
Bin ZhangDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, Guangdong, China. binzhang_cardio@163.com.

Funding

Guangdong Basic and Applied Basic Research Foundation-Provincial Enterprise Joint Fund 2022A1515220113National Natural Science Foundation of China 82103910
6 · The paper itself

Abstract

backgroundData on the safety and prognostic implications of retrograde percutaneous coronary intervention (PCI) in patients with low left ventricular ejection fraction (LVEF) and chronic total occlusion (CTO) are unclear. This study aimed to assess the procedural results and long-term outcomes of retrograde CTO PCI in individuals with reduced LVEF (≤ 40%).

methodsWe conducted a retrospective analysis of 836 consecutive patients who underwent elective retrograde CTO PCI at a single center between January 2011 and April 2023. Patients and lesion characteristics, procedural details and results, and long-term outcomes were compared between patients with reduced (LVEF ≤ 40%) and preserved left ventricular systolic function (LVEF > 40%) based on echocardiographic assessment.

resultsBaseline LVEF ≤ 40% was presented in 156 (18.7%) patients. The collateral channel (CC) tracking success was high (overall 93.5%) and similar among the groups (94.2% vs. 93.4%, p = 0.835), as well as retrograde technical success (87.8% vs. 89.9%, p = 0.548) and recanalization success (87.8% vs. 91.5%, p = 0.281). Procedure complications were low and similar between the groups (all p > 0.05). Clinical follow-up was available in 767 (91.2%) patients with a medium follow-up of 1041 (531-1511) days. In patients with lower LVEF, the incidence of MACE was higher (23.2% vs. 14.9%, p = 0.021), mainly the all-cause mortality (15.4% vs. 4.1%, p < 0.001) and cardiac death (12.2% vs. 2.5%, p < 0.001). Multivariable analysis revealed that age (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.01-1.04, p = 0.008), LVEF ≤ 40% (HR: 1.21, 95%CI: 1.01-1.45, p = 0.039), and revascularization success (HR: 0.38, 95% CI: 0.22-0.66, p < 0.001) were independently associated with MACE.

conclusionsRetrograde PCI may represent a safe and efficient management strategy for patients with reduced LVEF and CTO. Furthermore, our study demonstrated that successful CTO recanalization was associated with a significant survival benefit, regardless of left ventricular systolic function.

Indexed as

Coronary OcclusionPercutaneous Coronary InterventionPostoperative ComplicationsVentricular Dysfunction, LeftAgedChinaEchocardiographyFemaleHumansMaleMiddle AgedRetrospective StudiesStroke VolumeTreatment OutcomeVentricular Function, LeftChronic total occlusionClinical outcomesLeft ventricular ejection fractionPercutaneous coronary interventionRetrograde

Identifiers

PMID39985700

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