The role of chronic total occlusions in non-infarct-related arteries in acute coronary syndrome patients: a systematic review.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Future cardiology Pub Date : 2024-01-01 Epub Date: 2024-10-09 DOI:10.1080/14796678.2024.2406651
Hussein Sliman, Rim Kasem Ali Sliman, Paul Knaapen, Alex Nap, Jose Henriques, Niels Verouden, Bimmer EPM Claessen
{"title":"The role of chronic total occlusions in non-infarct-related arteries in acute coronary syndrome patients: a systematic review.","authors":"Hussein Sliman, Rim Kasem Ali Sliman, Paul Knaapen, Alex Nap, Jose Henriques, Niels Verouden, Bimmer EPM Claessen","doi":"10.1080/14796678.2024.2406651","DOIUrl":null,"url":null,"abstract":"<p><p><b>Aim:</b> This systematic review evaluated the impact of a chronic total occlusion (CTO) in a non-infarct-related artery (non-IRA) on clinical outcomes in acute coronary syndrome (ACS) patients and assessed the benefits of staged revascularization.<b>Methods:</b> We performed a comprehensive systematic review to provide further insight into the impact of a CTO in a non-IRA on clinical outcomes after ACS. Moreover, we review the currently available evidence on the clinical significance of staged revascularization for a CTO in a non-IRA patients with ACS and propose whether prophylactic CTO percutaneous coronary intervention (PCI) could improve outcomes in patients who subsequently develop an ACS.<b>Results:</b> Our search identified 999 studies, from which 30 were selected and ten were included in the analysis. The results showed a trend of higher all-cause mortality and major adverse cardiac event rates in the culprit-only-PCI group compared with the multivessel (MV)-PC I group in ST elevation myocardial infarction patients, with varying statistical significance across different outcomes.<b>Conclusion:</b> This review highlights the significant impact of non-IRA CTOs in ACS. Successful CTO revascularization may provide benefits, particularly in ST elevation myocardial infarction, but the optimal management approach remains uncertain. The presence of a non-IRA CTO, especially in cardiogenic shock, predicts worse outcomes. Further research is warranted to determine the effective strategies to improve survival.</p>","PeriodicalId":12589,"journal":{"name":"Future cardiology","volume":"20 10","pages":"581-590"},"PeriodicalIF":1.6000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485808/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Future cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14796678.2024.2406651","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/9 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Aim: This systematic review evaluated the impact of a chronic total occlusion (CTO) in a non-infarct-related artery (non-IRA) on clinical outcomes in acute coronary syndrome (ACS) patients and assessed the benefits of staged revascularization.Methods: We performed a comprehensive systematic review to provide further insight into the impact of a CTO in a non-IRA on clinical outcomes after ACS. Moreover, we review the currently available evidence on the clinical significance of staged revascularization for a CTO in a non-IRA patients with ACS and propose whether prophylactic CTO percutaneous coronary intervention (PCI) could improve outcomes in patients who subsequently develop an ACS.Results: Our search identified 999 studies, from which 30 were selected and ten were included in the analysis. The results showed a trend of higher all-cause mortality and major adverse cardiac event rates in the culprit-only-PCI group compared with the multivessel (MV)-PC I group in ST elevation myocardial infarction patients, with varying statistical significance across different outcomes.Conclusion: This review highlights the significant impact of non-IRA CTOs in ACS. Successful CTO revascularization may provide benefits, particularly in ST elevation myocardial infarction, but the optimal management approach remains uncertain. The presence of a non-IRA CTO, especially in cardiogenic shock, predicts worse outcomes. Further research is warranted to determine the effective strategies to improve survival.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
急性冠状动脉综合征患者非梗死相关动脉慢性全闭塞的作用:系统综述。
目的:本系统性综述评估了非梗死相关动脉(非IRA)慢性全闭塞(CTO)对急性冠状动脉综合征(ACS)患者临床预后的影响,并评估了分阶段血管重建的益处:我们进行了一项全面的系统综述,以进一步了解非 IRA 中的 CTO 对 ACS 后临床预后的影响。此外,我们还回顾了目前关于对非 IRA ACS 患者的 CTO 进行分期血管再通的临床意义的现有证据,并提出了预防性 CTO 经皮冠状动脉介入治疗(PCI)是否能改善随后发生 ACS 的患者的预后:我们的搜索发现了 999 项研究,从中筛选出 30 项,10 项纳入分析。结果显示,在ST段抬高的心肌梗死患者中,与多血管(MV)-PC I组相比,单纯罪魁祸首-PCI组的全因死亡率和主要不良心脏事件发生率呈上升趋势,不同结果的统计学意义各不相同:本综述强调了非IRA CTO对ACS的重大影响。成功的 CTO 血管再通可带来益处,尤其是在 ST 波抬高型心肌梗死中,但最佳的管理方法仍不确定。非 IRA CTO 的存在,尤其是在心源性休克时,预示着较差的预后。有必要开展进一步研究,以确定提高存活率的有效策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Future cardiology
Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.80
自引率
5.90%
发文量
87
期刊介绍: Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.
期刊最新文献
Primary congenital abdominal aortic aneurysm associated with renovascular hypertension in pediatric patient. Operation in the gray zone: is SAVR still useful in patients aged between 75 and 80 years? Current approach to atherosclerotic cardiovascular disease risk prediction. Robotic magnetic-guided catheter ablation: an emerging treatment for congenital heart disease. Electrocardiographic and biochemical predictors of left ventricular remodeling early after ST-segment elevation myocardial infarction.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1