The impact of revascularization on cardiac function and prognosis in patients with chronic total occlusion of a single coronary artery
SUN Gang
ZHANG Xue-fang
MO Zi-qing
LIN Rong-jie
LIANG Yong-yao
ZHANG Gao-xing
Abstract：Objective To observe the impact of revascularization on cardiac function and prognosis in patients with chronic total occlusion(CTO)of a single coronary artery.Methods This was a retrospective study.A total of 102 patients who were hospitalized in the cardiology department of Jiangmen Central Hospital from January 2020 to December 2022,diagnosed with single-vessel coronary artery CTO lesions(with other coronary artery stenosis less than 70％and not requiring intervention)and underwent percutaneous coronary intervention(PCI)treatment were enrolled.According to the results of the intervention,they were divided into a successful group(74 cases)and a failed group(28 cases).We collected the testing indicators of patients before PCI,within 3 months and after 12 months post-PCI,including hemoglobin(HGB),troponin Ⅰ(TnⅠ),Serum creatinine(Scr),low-density lipoprotein cholesterol(LDL-C),N-terminal brain natriuretic peptide premise(NT-proBNP),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),and other related indicators,and all complications and major adverse cardiovascular events(MACE)during and after PCI in all patients were collected.Meantime,a subgroup analysis of the patients in the successful group was conducted to observe the impact of different target vessels revascularizations on cardiac function.Results The NT-proBNP levels in the successful group of patients were significantly different compared to pre-PCI levels at both within 3 months[(1731.00±1434.11)pg/ml vs(2681.35±2576.17)pg/ml,P=0.002 and beyond 12 months[(772±700.90)pg/ml vs(2681.35±2576.17)pg/ml,P＜0.001].Similarly,the LVEF also showed differences compared to pre-PCI levels[(49.15±8.64)％vs(45.99±9.31)％,P=0.032;(52.84±8.02)％vs(45.99±9.31)％,P＜0.001],there was no difference in LVEDD within 3 months after PCI compared to before the procedure,but it significantly decreased beyond 12 months after PCI[(49.81±6.45)mm compared to(54.72±7.44)mm,P＜0.001];There were no differences in NT-proBNP,LVEDD,and LVEF before and after PCI in the failed group.In the subgroup analysis,the left anterior descending artery(LAD)[BNP:(1727.04±1509.03)pg/ml compared to(3005.79±2556.64)pg/ml,P=0.016 and(633±567.14)pg/ml compared to(3005.79±2556.64)pg/ml,P＜0.001;LVEF:(45.74±6.90)％compared to(41.08±7.61)％,P=0.032 and(50.65±7.27)％compared to(41.08±7.61)％,P＜0.001;LVEDD:(48.75±6.40)mm compared to(55.87±8.22)mm,P=0.002]and the right coronary artery(RCA)[BNP:(1656.55±1487.10)pg/ml compared to(2649.89±2892.95)pg/ml,P=0.042 and(616.35±528.40)pg/ml compared to(2649.89±2892.95)pg/ml,P＜0.001;LVEF:(53.59±8.15)％compared to(47.24±9.15)％,P=0.003;LVEDD:(49.71±6.28)mm compared to(54.27±7.31)mm,P=0.004]showed significant improvement in cardiac function indicators after revascularization,but the opening of the left circumflex artery(LCX)has no significance for improving heart function.There was no difference in the incidence of complications and MACE during and after PCI between two groups,but the frequency of angina attacks was reduced in the successful group(x2=53.175,P＜0.001).Conclusion Coronary CTO recanalization could improve patients'cardiac function and reduce the occurrence of angina,with recanalization of the LAD and RCA being particularly significant.
Keywords：Chronic total occlusionCardiac functionInterventional therapy
Publication Date：2024-10-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 878-883 )