Abstract

Background: Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and high target failure. The impact of percutaneous coronary intervention (PCI) for CTO in non-elderly patients is not clear. We evaluated the 12-month clinical outcomes between PCI and optimal medical therapy (OMT) for CTO lesions in non-elderly patients

Methods: A total of 321 consecutive CTO patients with ages lower than 65 were divided into 2 groups according to treatment strategy; PCI group (n=170) and OMT group (n=151). 12-month clinical outcomes were compared between the two groups.

Results: At baseline, the OMT group showed a higher prevalence of cerebrovascular accidents, stroke, peripheral vascular disease, de novo lesion, left main disease, multivessel disease, multivessel CTO, RCA-CTO, and well-developed collateral vessels (≥grade 2). The PCI group showed a higher prevalence of prior PTCA and LAD-CTO lesion. Clinical outcomes at 12 months were similar between the 2 groups except higher rates of TLR in the PCI group. Baseline adjustment by multivariate analysis showed similar results.

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Conclusions: In our study, there was no difference between PCI and optimal medical therapy for CTO in non-elderly patients. Long-term follow up with a larger study population will be necessary for further evaluation.