Contemporary Clinical Practices in Korean Patients With Coronary Chronic Total Occlusion: Results From the K-CTO Nationwide Retrospective Registry.
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Cha Jung-Joon, Lee Yonggu, Kim Dong-Eon, Kim Byeong-Keuk, Lee Seung-Jun, Rha Seung-Woon, Cho Jung Rae, Han Jung-Kyu, Hwang Doyeon, Kim Ung, Kook Hyungdon, Hwang Byung-Hee, Oh Gyu Chul, Lee Seung-Whan, Kim Tae Oh, Lee Jung-Hee, Jang Ji-Yong, Jang Youngwoo, Kim Chan Joon, Won Hoyoun, Yoon Chang-Hwan, Hahn Joo-Yong, Cho Jae Young, Seo Suk Min, Kim Dong-Kie, Park Gyung-Min, Shin Sanghoon, Lee Jin Bae, Park Ha-Wook, Kim Je Sang, Lee Kyusup, Lee Jang Hoon, Her Sung-Ho, Bae Jang-Whan, Jin Han-Young, Yoon Hyuck-Jun, Lee Jae-Hwan, Park Sang-Ho, Yu Cheol Woong, Suh Jon
Аннотация
METHODS: The Korean Chronic Total Occlusion (K-CTO) registry 2.0 is a nationwide retrospective registry including patients diagnosed with CTO between 2003 and 2023 at 34 centers performing percutaneous coronary intervention (PCI), irrespective of CTO-PCI performance. Demographic, clinical, procedural, and outcome data were analyzed.
RESULTS: Of 9,316 patients with CTO, 7,267 (78.0%) underwent PCI. The overall procedural success rate was 82.2%. The antegrade approach was used in 87.5% of cases and the retrograde in 12.5%, with procedural success rates of 82.8% and 78.5%, respectively. Intravascular ultrasonography was employed in 37.3%, and drug-eluting stents were implanted in 76.8%. Predictors of PCI attempts included younger age, prior PCI, and stable angina, whereas diabetes mellitus (DM), chronic kidney disease (CKD), prior CABG, and higher Japanese CTO scores were associated with less frequent PCI attempts. In-hospital all-cause mortality was 2.3% and periprocedural myocardial infarction (MI) 4.4%. At a median follow-up of 651 days, 5-year cumulative incidences of major adverse cardiac and cerebrovascular events, major adverse cardiac events, net adverse clinical events, and all-cause mortality were 30.4%, 28.5%, 30.9%, and 14.5%, respectively.
CONCLUSIONS: In routine practice across South Korea, most patients with CTO underwent PCI with high success. These descriptive findings should not be interpreted as evidence of improved long-term outcomes. Broader adoption of advanced techniques and device accessibility may further improve results in complex CTO lesions.