TCT-358 Impact of Periprocedural Myocardial Infarction following Chronic Total Occlusion Interventions on mid-term Angiographic and 2-year Clinical Outcomes

• Seung-Woon Rha¹, 
• Byoung Geol Choi¹, 
• Se Yeon Choi¹, 
• Yoonjee Park¹, 
• Raghavender Goud Akkala¹,
• Sunki Lee¹, 
• Ji Bak Kim¹, 
• Sung Il Im¹, 
• Jin oh Na¹, 
• Cheol Ung Choi¹, 
• Hong Euy Lim¹, 
• Jin Won Kim¹, 
• Eung Ju Kim¹, 
• Chang Gyu Park¹, 
• Hong Seog Seo¹, 
• Dong Joo Oh¹

• ¹ Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic of

Background

Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher recurrence. It is not clear whether the peri-procedural myocardial infarction (P-MI) will significantly impact on angiographic and clinical outcomes following CTO intervention.

Methods

A total of 131 consecutive pts underwent CTO intervention were divided into P-MI (n=12) and control group (n=119). Six-month angiographic and twelve-month clinical outcomes were compared between the two groups.

Results

The baseline clinical characteristics were balanced between the two groups except more elderly (66.1±13.0 vs. 60.1±9.4 p=0.034) in the P-MI group. There were higher incidence of perforation (15.3% vs. 0.7%, p=0.0005), dissection (46.1% vs.18.1%, p=0.018), any hematoma and acute renal failure in the P-MI group. Angiographic outcomes at 6 months were not different between the two groups. However, the incidence of total death, any myocardial infarction (MI) and target vessel revascularization (TVR)-major adverse cardiac events (MACE) were higher in the P-MI group at 24 months (Table).

Conclusions

P-MI following CTO intervention was associated with higher 2-year mortality, any MI and TVR-MACE. Careful procedure to minimize P-MI will be warranted to get optimal CTO intervention outcomes.