+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Meta-analysis of the impact of successful chronic total occlusion percutaneous coronary intervention on left ventricular systolic function and reverse remodeling



Meta-analysis of the impact of successful chronic total occlusion percutaneous coronary intervention on left ventricular systolic function and reverse remodeling



Journal of Interventional Cardiology 31(5): 562-571



We sought to examine the impact of coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on left ventricular (LV) function. We performed a systematic review and meta-analysis of studies published between January 1980 and November 2017 on the impact of successful CTO PCI on LV function. A total of 34 observational studies including 2735 patients were included in the meta-analysis. Over a weighted mean follow-up of 7.9 months, successful CTO PCI was associated with an increase in LV ejection fraction by 3.8% (95%CI 3.0-4.7, P < 0.0001, I2  = 45%). In secondary analysis of 15 studies (1248 patients) that defined CTOs as occlusions of at least 3-month duration and reported follow-up of at least 3-months after the procedure, successful CTO PCI was associated with improvement in LV ejection fraction by 4.3% (95%CI [3.1, 5.6], P < 0.0001). In the 10 studies (502 patients) that reported LV end-systolic volume, successful CTO PCI was associated with a decrease in LV end-systolic volume by 4 mL, (95%CI -6.0 to -2.1, P < 0.0001, I2  = 0%). LV end-diastolic volume was reported in 9 studies with 403 patients and did not significantly change after successful CTO PCI (-2.3 mL, 95%CI -5.7 to 1.2 mL, P = 0.19, I2  = 0%). Successful CTO PCI is associated with a statistically significant improvement in LV ejection fraction and decrease in LV end-systolic volume, that may reflect a beneficial effect of CTO recanalization on LV remodeling. The clinical implications of these findings warrant further investigation.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065310770

Download citation: RISBibTeXText

PMID: 29974508

DOI: 10.1111/joic.12538


Related references

Meta-analysis on the impact of percutaneous coronary intervention of chronic total occlusions on left ventricular function and clinical outcome. International Journal of Cardiology 187: 90-96, 2015

Impact of right ventricular side branch occlusion during percutaneous coronary intervention of chronic total occlusions on right ventricular function. Cardiovascular Revascularization Medicine 18(6): 405-410, 2017

Comparison of Benefit of Successful Percutaneous Coronary Intervention for Chronic Total Occlusion in Patients With Versus Without Reduced (≤40%) Left Ventricular Ejection Fraction. American Journal of Cardiology 120(10): 1780-1786, 2017

TCTAP A-048 Assessment of Left Ventricular Function Pre and Post Percutaneous Coronary Intervention to Chronic Total Coronary Occlusion Doppler Tissue Imaging Study. Journal of the American College of Cardiology 65(17): S25-S26, 2015

Effects of successful percutaneous coronary intervention of chronic total occlusions on myocardial perfusion and left ventricular function. Eurointervention 13(3): 345-354, 2017

Rationale and design of EXPLORE: a randomized, prospective, multicenter trial investigating the impact of recanalization of a chronic total occlusion on left ventricular function in patients after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Trials 11: 89, 2010

The impact of percutaneous coronary intervention of chronic total occlusions on left ventricular function and clinical outcomes. Journal of Thoracic Disease 7(7): 1107-1110, 2015

Effects of percutaneous revascularization of chronic total occlusions on clinical outcomes: a meta-analysis comparing successful versus failed percutaneous intervention for chronic total occlusion. Catheterization and Cardiovascular Interventions 82(1): 95, 2013

Evaluation of the effect of a concurrent chronic total occlusion on long-term mortality and left ventricular function in patients after primary percutaneous coronary intervention. Jacc. Cardiovascular Interventions 2(11): 1128-1134, 2009

Late percutaneous recanalization of chronic total coronary occlusion after myocardial infarction improves global and regional left ventricular function and avoids remodeling in the absence of subsequent reocclusion. Circulation 92(8 Suppl. ): I74, 1995

Successful percutaneous coronary intervention of total chronic occlusion of the left main coronary artery: A feasible option?. International Journal of Cardiology 229: 19-20, 2017

Impact of left ventricular systolic function on the outcomes of percutaneous coronary intervention for unprotected left main disease. Zhonghua Yi Xue Za Zhi 91(34): 2388-2391, 2011

Successful Percutaneous Coronary Intervention for Chronic Total Occlusion of Left Anterior Descending Coronary Artery in a Patient with Dextrocardia. International Journal of Angiology 25(5): E70-E72, 2016

Effect of a successful percutaneous coronary intervention for chronic total occlusion on parameters of ventricular repolarization. Coronary Artery Disease 25(8): 705-712, 2014

Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention in Patients With Left Ventricular Systolic Dysfunction: A Meta-Analysis. Angiology 68(1): 19-28, 2017