CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial Dual-antiplatelet treatment beyond 1 year after drug-eluting stent implantation (ARCTIC-Interruption): a randomised trial Third-Generation Balloon and Self-Expandable Valves for Aortic Stenosis in Large and Extra-Large Aortic Annuli From the TAVR-LARGE Registry Noninvasive Nuclear SPECT Myocardial Blood Flow Quantitation to Guide Management for Coronary Artery Disease Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the Efficacy of Xience/Promus Versus Cypher to Reduce Late Loss After Stenting (EXCELLENT) randomized, multicenter study Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Impact of Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation on Patients With Chronic Kidney Disease: Subgroup Analysis From ULTIMATE Trial Clopidogrel or ticagrelor in acute coronary syndrome patients treated with newer-generation drug-eluting stents: CHANGE DAPT
|<<... 95 96 97 98 99 100 101 ...>>|

Clinical TrialPublished on 26 September 2017

JOURNAL：EuroIntervention. Article Link

Clinical Implications of Periprocedural Myocardial Injury in Patients Undergoing Percutaneous Coronary Intervention for Chronic Total Occlusion: Role of Antegrade and Retrograde Crossing Techniques

Toma A, Stähli B, Gebhard C et al. Keywords: myocardial infarction; stable angina; death; Chronic coronary total occlusion

ABSTRACT


AIMS - Periprocedural myocardial injury (PMI) is frequently observed after percutaneous coronary interventions (PCI) for chronic total occlusion (CTO). We investigated the prognostic impact of PMI with the antegrade or the retrograde crossing technique.


METHODS AND RESULTS - A total of 1909 patients undergoing CTO PCI were stratified according to the presence/absence of PMI (elevation of cardiac troponin T [cTnT] >5x 99th percentile of normal), and divided according to tertiles of the difference between peak and baseline cTnT within 24 hours (ΔcTnT). The primary endpoint was all-cause mortality at a median follow-up of 3.1 (interquartile range 3.0-4.4) years. PMI occurred in 19.4% and 25.4% after antegrade (n=1447) and retrograde (n=462) procedures (p<0.001). PMI was significantly associated with mortality after antegrade (adjusted HR 1.39, 95% CI 1.02-1.88, p=0.04), but not retrograde CTO PCI (adjusted HR 0.93,95% CI 0.53-1.63, p=0.80, Pint=0.02). With the antegrade, but not the retrograde approach, mortality also increased with tertiles of ΔcTnT (T1: 11.0%, T2: 18.6%, T3: 21.6%, Log Rank p<0.001).


CONCLUSIONS - Periprocedural myocardial injury was significantly associated with all-cause mortality following antegrade, but not retrograde CTO PCI. Hence, the higher risk of PMI following retrograde procedures did not translated into worse survival.

>CBS CBS 2019

> CBS 2019

> CBS 2019 注册

> CBS 2019 会议日程

> CBS 2019 学术征集

> CBS 2019 热点

 CBSMD

> CBSMD 网站注册

> 教育中心

> 荐读文献

> Top 10 阅读文献

> 文献导读
CBS 2019 CBS 2019 主席团 教育中心 科研动态
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top