Predictive factors and one-year outcomes following successful contemporary chronic total occlusions percutaneous coronary interventions

Background: We aimed to explore the predictive factors and one-year clinical outcomes following successful contemporary CTO-PCI. Methods: Consecutive patients from January 2018 to December 2020 were enrolled. The primary endpoint was major adverse cardiovascular events (MACE) which included all-cause death and myocardial infarction, while target vessel revascularization (TVR) was defined as the secondary endpoint, all of which were measured at 12 months. Results: A total of 830 patients were treated by successful CTO PCI, and 96.7% of these cases were available with one-year follow-up data (n=803). The incidence of MACE was observed in 27 patients (3.4%), with all-cause death occurring in 21 cases (2.6%) and myocardial infarction in 6 cases (0.7%). TVR occurred in 35 patients (4.4%). The multivariate predictive factor analysis for MACE indicated that LVEF <40% ( P =0.007) and residual SYNTAX score ≥ 12 ( P <0.001) were identified as independent risk factors for MACE. While prior PCI ( P =0.017) and aspirin usage at discharge ( P <0.001) were protective factors. Parallelly, prior PCI ( P =0.003), ambiguity proximal cap ( P =0.006), and guide-wire manipulation time (GMT) ( P =0.008) were independent risk factors for TVR, while LAD-CTO presence ( P =0.045) and stent implantation ( P =0.001) were protective factors. Conclusion: Patients deserved favorable outcomes and a low incidence of adverse events after one year following successful contemporary CTO PCI.