title: Quality of life benefits of percutaneous coronary intervention for chronic occlusions.
abstract: OBJECTIVE
  We aimed to compare quality of life benefits of percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) with non-CTO PCI.
  
  
  BACKGROUND
  Data quantifying the benefits of PCI of CTO are inconsistent.
  
  
  METHODS
  We leveraged a 10-center prospective PCI registry including Seattle Angina Questionnaire (SAQ) assessment at the time of PCI and in follow-up. We propensity matched attempted CTO PCIs with up to 10 non-CTO PCIs. The primary analysis compared changes between baseline and 6 months in SAQ Physical Limitation (PL), Quality of Life (QoL); Angina Frequency (AF) scores as well as the Rose Dyspnea scores (RDS) and the EQ5D Visual Analogue Scale (VAS). Noninferiority was assessed for quality of life changes between CTO and non-CTO PCI.
  
  
  RESULTS
  In 3,303 patients enrolled, 167 single-vessel CTOs were attempted; 147 (88%) were matched with 1,616 non-CTO PCI. Baseline PL (73.0 vs. 77.4, P = 0.039) and VAS (66.4 vs. 70.8, P = 0.005) scores were lower for CTO. There was no difference in AF, QoL, or RDS scores. At 6-month follow-up, all SAQ scores improved (P < 0.05 vs. baseline for all) and were equivalent for CTO and Non-CTO (P = NS for all). VAS scores remained lower for CTO, but improved in both groups (P < 0.05 vs. baseline for both). Formal noninferiority testing demonstrated that CTO PCI was not inferior to non-CTO PCI (P ≤ 0.02 for all).
  
  
  CONCLUSIONS
  Symptoms, function, QoL, and dyspnea improve to the same degree following CTO PCI as compared with non-CTO PCI. Symptom relief supports CTO PCI to improve patients' quality of life.
authors.affiliation: Mid America Heart Institute, Division of Cardiovascular Research, St. Luke's Hospital, Kansas City, Missouri; Division of Cardiology, University of Missouri, Kansas City, Missouri.
authors.forename: David M
authors.initials: DM
authors.lastname: Safley
authors.forename: J Aaron
authors.initials: JA
authors.lastname: Grantham
authors.forename: Jason
authors.initials: J
authors.lastname: Hatch
authors.forename: Philip G
authors.initials: PG
authors.lastname: Jones
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease; D054059:Coronary Occlusion / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D057216:Propensity Score; D011788:Quality of Life; D020127:Recovery of Function; D012042:Registries; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: angioplasty; coronary occlusions; percutaneous coronary; transluminal