Michaella Alexandrou, Athanasios Rempakos, Deniz Mutlu, Ahmed Al Ogaili, Pedro E P Carvalho, Dimitrios Strepkos, James W Choi, Paul Poommipanit, Khaldoon Alaswad, Mir Babar Basir, Rhian Davies, Farouc A Jaffer, Phil Dattilo, Anthony H Doing, Lorenzo Azzalini, Nazif Aygul, Raj H Chandwaney, Brian K Jefferson, Sevket Gorgulu, Jaikirshan J Khatri, Laura D Young, Oleg Krestyaninov, Dmitrii Khelimskii, Jarrod Frizzell, Omer Goktekin, James D Flaherty, Daniel R Schimmel, Keith H Benzuly, Mahmut Uluganyan, Ramazan Ozdemir, Yousif Ahmad, Bavana V Rangan, Olga C Mastrodemos, M Nicholas Burke, Konstantinos Voudris, Yader Sandoval, Emmanouil S Brilakis
{"title":"慢性全闭塞经皮冠状动脉介入治疗中的外周动脉疾病。","authors":"Michaella Alexandrou, Athanasios Rempakos, Deniz Mutlu, Ahmed Al Ogaili, Pedro E P Carvalho, Dimitrios Strepkos, James W Choi, Paul Poommipanit, Khaldoon Alaswad, Mir Babar Basir, Rhian Davies, Farouc A Jaffer, Phil Dattilo, Anthony H Doing, Lorenzo Azzalini, Nazif Aygul, Raj H Chandwaney, Brian K Jefferson, Sevket Gorgulu, Jaikirshan J Khatri, Laura D Young, Oleg Krestyaninov, Dmitrii Khelimskii, Jarrod Frizzell, Omer Goktekin, James D Flaherty, Daniel R Schimmel, Keith H Benzuly, Mahmut Uluganyan, Ramazan Ozdemir, Yousif Ahmad, Bavana V Rangan, Olga C Mastrodemos, M Nicholas Burke, Konstantinos Voudris, Yader Sandoval, Emmanouil S Brilakis","doi":"10.25270/jic/24.00196","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The impact of peripheral artery disease (PAD) on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is not well studied.</p><p><strong>Methods: </strong>We analyzed the association of PAD with CTO-PCI outcomes using data from the PROGRESS-CTO registry of procedures performed at 47 centers between 2012 and 2023.</p><p><strong>Results: </strong>The prevalence of PAD among 12 961 patients who underwent CTO PCI during the study period was 13.9% (1802). PAD patients were older, more likely to be current smokers, and had higher rates of dyslipidemia, diabetes, cerebrovascular disease, hypertension, prior myocardial infarction, PCI, and coronary artery bypass graft surgery. Their PROGRESS-CTO (1.35 vs 1.22; P < .001) and J-CTO (2.63 vs 2.33; P < .001) scores were higher, lesion length was longer, and angiographic characteristics were more complex. Their access site was more likely to be bifemoral (33.6% vs 30.9%; P = .024) compared with patients with no PAD. Technical (82.9% vs 87.7%; P < .001) and procedural (80.5% vs 86.6%; P < .001) success rates were lower in patients with PAD, while the incidence of major adverse cardiovascular events (MACE) was higher (3.1% vs 1.8%; P < .001), with higher mortality (0.8% vs 0.4%; P = .034), acute myocardial infarction rate (0.9% vs 0.4%; P = .010), and perforations rate (6.6% vs 4.5%; P < .001). In multivariable analysis, PAD was associated with higher MACE (odds ratio [OR]: 1.53; 95% CI, 1.01-2.26; P = .038) and lower technical success (OR: 0.82; 95% CI, 0.69-0.99; P = .039).</p><p><strong>Conclusions: </strong>PAD patients undergoing CTO PCI have higher comorbidity burden, more complex CTOs, higher MACE, and lower technical success.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Peripheral artery disease in chronic total occlusion percutaneous coronary intervention.\",\"authors\":\"Michaella Alexandrou, Athanasios Rempakos, Deniz Mutlu, Ahmed Al Ogaili, Pedro E P Carvalho, Dimitrios Strepkos, James W Choi, Paul Poommipanit, Khaldoon Alaswad, Mir Babar Basir, Rhian Davies, Farouc A Jaffer, Phil Dattilo, Anthony H Doing, Lorenzo Azzalini, Nazif Aygul, Raj H Chandwaney, Brian K Jefferson, Sevket Gorgulu, Jaikirshan J Khatri, Laura D Young, Oleg Krestyaninov, Dmitrii Khelimskii, Jarrod Frizzell, Omer Goktekin, James D Flaherty, Daniel R Schimmel, Keith H Benzuly, Mahmut Uluganyan, Ramazan Ozdemir, Yousif Ahmad, Bavana V Rangan, Olga C Mastrodemos, M Nicholas Burke, Konstantinos Voudris, Yader Sandoval, Emmanouil S Brilakis\",\"doi\":\"10.25270/jic/24.00196\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The impact of peripheral artery disease (PAD) on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is not well studied.</p><p><strong>Methods: </strong>We analyzed the association of PAD with CTO-PCI outcomes using data from the PROGRESS-CTO registry of procedures performed at 47 centers between 2012 and 2023.</p><p><strong>Results: </strong>The prevalence of PAD among 12 961 patients who underwent CTO PCI during the study period was 13.9% (1802). PAD patients were older, more likely to be current smokers, and had higher rates of dyslipidemia, diabetes, cerebrovascular disease, hypertension, prior myocardial infarction, PCI, and coronary artery bypass graft surgery. Their PROGRESS-CTO (1.35 vs 1.22; P < .001) and J-CTO (2.63 vs 2.33; P < .001) scores were higher, lesion length was longer, and angiographic characteristics were more complex. Their access site was more likely to be bifemoral (33.6% vs 30.9%; P = .024) compared with patients with no PAD. Technical (82.9% vs 87.7%; P < .001) and procedural (80.5% vs 86.6%; P < .001) success rates were lower in patients with PAD, while the incidence of major adverse cardiovascular events (MACE) was higher (3.1% vs 1.8%; P < .001), with higher mortality (0.8% vs 0.4%; P = .034), acute myocardial infarction rate (0.9% vs 0.4%; P = .010), and perforations rate (6.6% vs 4.5%; P < .001). In multivariable analysis, PAD was associated with higher MACE (odds ratio [OR]: 1.53; 95% CI, 1.01-2.26; P = .038) and lower technical success (OR: 0.82; 95% CI, 0.69-0.99; P = .039).</p><p><strong>Conclusions: </strong>PAD patients undergoing CTO PCI have higher comorbidity burden, more complex CTOs, higher MACE, and lower technical success.</p>\",\"PeriodicalId\":49261,\"journal\":{\"name\":\"Journal of Invasive Cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-08-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Invasive Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.25270/jic/24.00196\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Invasive Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.25270/jic/24.00196","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：外周动脉疾病（PAD）对慢性全闭塞（CTO）经皮冠状动脉介入治疗（PCI）结果的影响尚未得到充分研究：外周动脉疾病（PAD）对慢性全闭塞（CTO）经皮冠状动脉介入治疗（PCI）结果的影响尚未得到充分研究：我们使用 PROGRESS-CTO 登记的数据分析了 PAD 与 CTO-PCI 治疗效果的关系，这些数据来自 2012 年至 2023 年期间在 47 个中心进行的手术：在研究期间接受 CTO PCI 的 12 961 名患者中，PAD 患病率为 13.9%（1802 人）。PAD患者年龄较大，更有可能是吸烟者，血脂异常、糖尿病、脑血管疾病、高血压、既往心肌梗死、PCI和冠状动脉旁路移植手术的发生率较高。他们的 PROGRESS-CTO (1.35 vs 1.22; P < .001) 和 J-CTO (2.63 vs 2.33; P < .001) 评分更高，病变长度更长，血管造影特征更复杂。与无 PAD 患者相比，他们的入路部位更可能是双股动脉（33.6% vs 30.9%; P = .024）。PAD患者的技术成功率（82.9% vs 87.7%；P < .001）和手术成功率（80.5% vs 86.6%；P < .001）较低，而主要不良心血管事件（MACE）的发生率较高（3.1% vs 1.8%；P < .001），死亡率（0.8% vs 0.4%；P = .034）、急性心肌梗死率（0.9% vs 0.4%；P = .010）和穿孔率（6.6% vs 4.5%；P < .001）更高。在多变量分析中，PAD 与较高的 MACE（几率比 [OR]：1.53；95% CI，1.01-2.26；P = .038）和较低的技术成功率（OR：0.82；95% CI，0.69-0.99；P = .039）相关：结论：接受CTO PCI治疗的PAD患者合并症负担更高、CTO更复杂、MACE更高、技术成功率更低。
Peripheral artery disease in chronic total occlusion percutaneous coronary intervention.
Background: The impact of peripheral artery disease (PAD) on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is not well studied.
Methods: We analyzed the association of PAD with CTO-PCI outcomes using data from the PROGRESS-CTO registry of procedures performed at 47 centers between 2012 and 2023.
Results: The prevalence of PAD among 12 961 patients who underwent CTO PCI during the study period was 13.9% (1802). PAD patients were older, more likely to be current smokers, and had higher rates of dyslipidemia, diabetes, cerebrovascular disease, hypertension, prior myocardial infarction, PCI, and coronary artery bypass graft surgery. Their PROGRESS-CTO (1.35 vs 1.22; P < .001) and J-CTO (2.63 vs 2.33; P < .001) scores were higher, lesion length was longer, and angiographic characteristics were more complex. Their access site was more likely to be bifemoral (33.6% vs 30.9%; P = .024) compared with patients with no PAD. Technical (82.9% vs 87.7%; P < .001) and procedural (80.5% vs 86.6%; P < .001) success rates were lower in patients with PAD, while the incidence of major adverse cardiovascular events (MACE) was higher (3.1% vs 1.8%; P < .001), with higher mortality (0.8% vs 0.4%; P = .034), acute myocardial infarction rate (0.9% vs 0.4%; P = .010), and perforations rate (6.6% vs 4.5%; P < .001). In multivariable analysis, PAD was associated with higher MACE (odds ratio [OR]: 1.53; 95% CI, 1.01-2.26; P = .038) and lower technical success (OR: 0.82; 95% CI, 0.69-0.99; P = .039).
Conclusions: PAD patients undergoing CTO PCI have higher comorbidity burden, more complex CTOs, higher MACE, and lower technical success.
期刊介绍：
The Journal of Invasive Cardiology will consider for publication suitable articles on topics pertaining to the invasive treatment of patients with cardiovascular disease.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
