Change in Hospitalization Rates After Percutaneous Coronary Intervention for Chronic Total Occlusion (from a Nationwide Cohort Sample)

• Published in: The American journal of cardiology 2021-03, Vol.142, p.141-143
• Main Authors: Elkaryoni, Ahmed, Elgendy, Islam Y., Genev, Ivo, Khalil, Mahmoud, Darki, Amir
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angioplasty; Blood vessels; Cardiac arrhythmia; Cardiovascular disease; Chest; Chest Pain - epidemiology; Chronic Disease; Cohort Studies; Congestive heart failure; Coronary artery; Coronary artery disease; Coronary Occlusion - physiopathology; Coronary Occlusion - surgery; Coronary vessels; Female; Heart failure; Heart Failure - epidemiology; Heart surgery; Hospitalization; Hospitalization - statistics & numerical data; Humans; Male; Myocardial Infarction - epidemiology; Occlusion; Pain; Patients; Percutaneous Coronary Intervention; Postoperative Period; Preoperative Period; Risk assessment; Signs and symptoms; Subgroups; Tachycardia; Tachycardia, Ventricular - epidemiology; Treatment Outcome; United States - epidemiology; Ventricle
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2020.12.011

Successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has been associated with improvement of disabling anginal symptoms in patients with maximal medical therapy, improvement of left ventricular function, and reduces risk of ventricular arrhythmias.1 Despite these benefits, patients continue to suffer from high hospitalization rates post-CTO PCI with chest pain being the most common cause.2 In order to better understand the influence of CTO PCI on hospitalization rates, we aimed to explore the change in hospitalization rates pre- and post-CTO PCI by using the Nationwide Readmission Database (NRD). The secondary outcomes included: (1) Change in 90-day hospitalization rates for heart failure, acute MI, chest pain without MI, and ventricular tachycardia-related hospitalizations; (2) a 30-day time frame analysis for the 90-day all-cause hospitalization rates pre- and post-CTO PCI; (3) change in all-cause 90-day hospitalization rates among key subgroups (Figure 1A). [...]we may have captured non-CTO PCI patients; however it is less likely since we limited our cohort to a single-vessel PCI, excluded patients with ACS event, and the current practice paradigm favors coronary artery bypass graft for patient with multivessel coronary artery disease.4 Finally, this analysis is restricted to inpatient procedures only, and does not capture outpatient CTO PCI, which is a big portion of this patient population with a possible different patient risk profile between both groups.Funding Self-funded.Disclosure The authors have nothing to disclose, and no relationship with industry.