Authors:	Blessing, Recha Keller, Karsten Dimitriadis, Zisis Münzel, Thomas Gori, Tommaso Hobohm, Lukas
Title:	Temporal trends of case-fatality in patients undergoing dual-injection coronary chronic total occlusion recanalization
Online publication date:	16-Jan-2024
Year of first publication:	2023
Language:	english
Abstract:	Aims Recently, interventional techniques and material to treat chronic total occlusion (CTO) with percutaneous coronary intervention (PCI) have evolved significantly. Nevertheless, it is still unknown whether this progress improved treatment success and patients’ outcome. In a nationwide sample, we sought to analyze trends of patients’ characteristics, complications and in-hospital case-fatality of patients undergoing CTO revascularization in Germany. Methods and Results We analyzed data on characteristics, treatments, and in-hospital outcomes for all coronary artery disease (CAD) patients (ICD-code I25) undergoing dual-injection CTO recanalization (OPS procedural code: 8–839.9) in Germany from 2009 to 2020. Overall, 4,998,457 inpatients aged ≥ 18 years with diagnosis of CAD were treated in German hospitals in this period. Among these, 52,879 patients (1.1%) underwent CTO recanalization. Annual number of CTO PCIs increased from 1263 in 2009 to 6435 in 2020 (β 3.48 [95% CI 3.44–3.52]; p < 0.001) in parallel with a significant decrease of case-fatality (2.2% in 2009 to 1.4% in 2020; β  – 0.60 [95% CI  – 0.82 to  – 0.39]; p < 0.001). Overall, 754 (1.4%) patients with CTO recanalization died during the in-hospital stay and in-hospital case-fatality grew exponentially with age (β 0.82 [95% CI 0.73–0.90]; p < 0.001). Significant predictors of in-hospital case fatality with an OR > 3 were cancer, stroke, hemopericardium, acute renal failure, pulmonary embolism and shock. Conclusion Annual number of CTO procedures performed in Germany increased from 2009 to 2020 with a concomitant anti-proportional decrease in the case-fatality. Our findings may help to draw more attention to predictors of in-hospital case fatality in patients hospitalized for CTO recanalization.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9838
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Clinical research in cardiology Version of Record (VoR)
Publisher:	Springer
Publisher place:	Berlin
Issue date:	2023
ISSN:	1861-0692
Publisher DOI:	10.1007/s00392-023-02298-x
Appears in collections:	DFG-491381577-H