Benefits of CTO-PCI in Selected Cases With HFrEF (CTOHFrEF)

Hospital Clinic of Barcelona

Status

Completed

Conditions

Chronic Total Occlusion Vessel

Treatments

Procedure: chronic total coronary occlusion percutaneous intervention

Study type

Interventional

Funder types

Other

Identifiers

NCT02570087

CTOHFrEF

Details and patient eligibility

About

The investigators studied the effect of CTO-PCI on left ventricular function and clinical parameters in patients with HFrEF.

Full description

Observational studies have shown that chronic total coronary occlusion percutaneous intervention (CTO-PCI) improves angina, left ventricular ejection fraction (LVEF), and survival. None of these studies aimed to assess the benefits in populations with heart failure with reduced ejection fraction (HFrEF). The investigators studied the effect of CTO-PCI on left ventricular function and clinical parameters in patients with HFrEF.

Using cardiac magnetic resonance (CMR), the investigators studied 29 patients with HFrEF and evidence of viability and/or ischemia in the territory supplied by an occluded vessel who were successfully treated with CTO-PCI. Non-CTO PCI was also performed in patients with multi-vessel disease, . Imaging parameters, clinical status, and brain natriuretic peptide (BNP) levels were evaluated before and six months after CTO-PCI.

Enrollment

39 patients

Sex

All

Ages

18 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

At least one chronic total coronary occlusion
LVEF ≤40% by CMR
Evidence of myocardial viability and/or ischemia in at least two contiguous segments subtended by the occluded vessel.

Exclusion criteria

Women of childbearing age or pregnant
Claustrophobia
Admission to hospital within the previous 90 days due to decompensated heart failure, myocardial infarction or unstable angina.
Severe valvulopathy
Pacemaker or implantable cardioverter defibrillator
Indication for coronary artery bypass surgery
Heart transplantation waiting list
Follow-up not feasible
Life expectancy shorter than 12 months.
Iodine contrast or gadolinium allergy
Aspirin or clopidogrel allergy
Asthma
NYHA IV class
Liver cirrosis
Noncompliance with medical treatment
Chronic kidney disease with serum creatinine levels ≥ 2.5 mg/dl or glomerular filtration rate ≤30 ml/min/1.73m2
Evidence of active bleeding
High risk of bleeding
CTO distal vessel not visible through collateral circulation
CTO distal vessel diameter <2mm
Absence of acceptable vascular access