| Objective To compare the long-term prognosis of interventional therapy and optimal medicine therapy in patients with chronic total occlusion(CTO),as well as those with good collateral circulation.Methods The study was a single center retrospective cohort study.From May 2015 to December 2019,361 patients with chronic total occlusion showed by coronary angiography were enrolled and divided into CTO-PCI group(n = 169)and CTO-OMT group(n = 192)according to different treatment strategies.Meanwhile,the collateral circulation of the 361 patients with CTO was evaluated by Rentrop classification,and the CTO patients with Rentrop ≥ 2 were defined as CTO patients with good collateral circulation.A total of 209 patients were enrolled as a subgroup to compare the prognosis,including 114 in CTO-PCI group and 95 in CTO-OMT group.Collect the patient’s general data,biochemical data,coronary angiography and other related data,and follow-up the occurrence of end-point events.Kaplan-Meier survival curve was used to describe the cumulative incidence of end-point events in the two groups,and log-rank test was used to compare the differences between the two groups.Cox proportional hazard model was used to analyze whether there is any difference in the long-term prognosis of PCI / OMT.Results The follow-up time was 15(10,33)months.In 361 patients with CTO,the incidence of MACCE(7.7% vs.18.8%,P = 0.003)and myocardial infarction(1.8% vs.9.4%,P = 0.007)were significantly different between CTO-PCI group and CTO-OMT group.In the 209 CTO subgroups with good collateral circulation,we found that the incidence of MACCE(7.9%vs 20.0%,p=0.010)and myocardial infarction(1.8% vs 10.5%,P=0.018).in the CTO-PCI group was still lower than that in the CTO-OMT group.There was no significant difference in other endpoint events.Conclusions The long-term prognosis of PCI treatment was better than OMT treatment in all CTO patients,and the same was true in CTO patients with good collateral circulation. |
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