PS 05-41 IMPACT OF HYPERTENSION ON 5-YEAR CLINICAL OUTCOMES IN PATIENTS WITH CORONARY CHRONIC TOTAL OCCLUSION LESION

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Abstract

Objective:

Hypertension (HTN) can worsen cardiovascular morbidity and mortality. However, there are limited data regarding the impact of HTN in patients (Pts) who have coronary chronic total occlusion (CTO) lesion on long-term clinical outcomes.

Design and Method:

A total of 822 consecutive CTO pts who underwent coronary angiography, receiving either percutaneous coronary intervention (PCI) or optimal medical treatment (OMT) were enrolled. Pts were divided into two groups according to the presence of HTN; 1) the HTN group (n = 536) and 2) Control group without HTN (n = 286). To adjust for potential confounders, a propensity score matching (PSM) analysis was performed using the logistic regression model. Individual major clinical outcomes and major adverse cardiac events (MACE), the composite of total death, myocardial infarction, stroke and revascularization, were compared between the two groups up to 5 years.

Results:

After PSM analysis, two propensity-matched groups (249 pairs, n = 498, C-statistic = 0.701) were generated and the baseline characteristics were well balanced. Up to 5 years, the HTN group showed higher incidence of stroke compared with the control group. However, there was no significant difference in the incidence of myocardial infarction, repeat revascularizations and MACE between the two groups up to 5 years.

Conclusions:

In this study, hypertensive pts with CTO was associated with higher stroke incidence up to 5 years and thus should be given more careful management during clinical follow-up.

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