{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:18:58Z","timestamp":1790734738037,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T00:00:00Z","timestamp":1568246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Limited research has detailed the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) with independent core laboratory and event adjudication. This study examined procedural, clinical, and patient\u2010reported health status outcomes among patients undergoing CTO PCI with specific focus on outcomes for those treated with zotarolimus\u2010eluting stents (ZES).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 500 consecutive patients undergoing attempted CTO PCI, procedural and in\u2010hospital clinical outcomes were examined in addition to the 1\u2010year composite endpoint of death, myocardial infarction, and target lesion revascularization (major adverse cardiac events, MACE). In a pre\u2010specified cohort of 250 patients, health status measures were ascertained at baseline and 1\u2009year. A powered secondary endpoint was 1\u2010year MACE among patients treated with ZES compared with a performance goal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Demographic, lesion, and procedural characteristics for the overall population included prior bypass surgery, 29.8%; diabetes, 35.2%; occlusion length &gt;20\u2009mm, 71.3%; J\u2010CTO score, 2.5\u2009\u00b1\u20091.1; and primary retrograde strategy, 30.8%. Overall guidewire crossing was 90.9%; clinical success following guidewire crossing, 94.3%; and 1\u2010year MACE rate, 12.1%. One\u2010year health status significantly improved from baseline with successful CTO\u2010PCI (angina frequency, 72.7\u2009\u00b1\u200926.5 at baseline to 96.0\u2009\u00b1\u200910.8, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). Compared with a performance goal derived from prior CTO DES trials (1\u2010year hierarchal MACE, 25.2%), treatment with ZES was associated with significantly lower MACE (18.2%, one\u2010sided upper CI, 23.6%, <jats:italic>p<\/jats:italic> = .017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Favorable procedural success, health status improvements and late\u2010term clinical outcomes inform the relative risks and benefits of CTO PCI when performed in a clinically indicated, complex patient population representative of those treated in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28494","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T07:03:52Z","timestamp":1568271832000},"page":"567-576","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Procedural, clinical, and health status outcomes in chronic total coronary occlusion revascularization: Results from the PERSPECTIVE study"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0868-6655","authenticated-orcid":false,"given":"David E.","family":"Kandzari","sequence":"first","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Lembo","sequence":"additional","affiliation":[{"name":"Division of Cardiology Columbia University Medical Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold D.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kalynych","sequence":"additional","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"Cardiovascular Research, Department of Biomedical and Health Informatics Saint Luke's Mid America Heart Institute\/UMKC  Kansas City Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Michael","family":"Gibson","sequence":"additional","affiliation":[{"name":"Division of Cardiology Beth Israel Deaconess Medical Center  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8371-1689","authenticated-orcid":false,"given":"Gerald","family":"Chi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Beth Israel Deaconess Medical Center  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayne","family":"Morgan","sequence":"additional","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Rinehart","sequence":"additional","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Yehya","sequence":"additional","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Qian","sequence":"additional","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bola","family":"Ajose","sequence":"additional","affiliation":[{"name":"Division of Cardiology Piedmont Heart Institute  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitri","family":"Karmpaliotis","sequence":"additional","affiliation":[{"name":"Division of Cardiology Columbia University Medical Center  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,12]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"ParkSJOptimal medical therapy with or without stenting for coronary chronic total occlusion: DECISION\u2010CTO. 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