Table 1.
Overview of Randomized Controlled Trials and Large Observational Studies That Compared CTO PCI With MT in Patients With Coronary CTOs
| Study (Author) Name | No. of Patients Enrolled | No. of Centers | Study Period | Study Design | Compared Study Groups | Primary End Point | Overall Success Rate, % | Follow‐Up Period | MACE Rate, % |
|---|---|---|---|---|---|---|---|---|---|
| Randomized trials | |||||||||
| EXPLORE (Henriques et al)5 | 304 | 14 | 2007–2015 | Randomized, prospective | Early CTO PCI after STEMI vs MT after STEMI | LVEF and LVEDV | 73 | 4 mo | 5.4 vs 2.6 |
| DECISION‐CTO (Park)6 | 834 | 19 | 2010–2016 | Randomized, prospective | CTO PCI vs OMT (non‐CTO PCI performed in both study groups) | Death, MI, stroke, TVR | 91.1 | 3 y | 19.0 vs. 21.4 |
| EURO‐CTO (Werner)7 | 407 | 26 | 2012–2015 | Randomized, prospective | CTO PCI vs OMT (non‐CTO PCI not performed) | Health status | 86.3 | 12 mo | 6.7 vs 5.2 |
| Observational studies | |||||||||
| IRCTO (Tomasello et al)9 | 1777 | 12 | 2008–2009 | Observational, prospective | PCI vs OMT vs CABG | MACCE, cardiac death | 75.4 | 1 y | 2.6 vs 8.2 vs 6.9 |
| Jang et al10 | 738 | 1 | 2003–2012 | Observational, retrospective | OMT+PCI/CABG vs OMT (all Rentrop 3 collateral filling grade.) | MACE, cardiac death | 80.1 | 42 mo | 3.4 vs 9.7 |
CABG indicates coronary artery bypass grafting; CTO, chronic total occlusion; DECISION‐CTO, Drug‐Eluting Stent Implantation Versus Optimal Medical Treatment in Patients with Chronic Total Occlusion; EURO‐CTO, Randomized Multicenter Trial to Evaluate the Utilization of Revascularization or Optimal Medical Therapy for the Treatment of Chronic Total Coronary Occlusions; EXPLORE, Evaluating Xience and Left Ventricular Function in Percutaneous Coronary Intervention on Occlusions After ST‐Elevation Myocardial Infarction; IRCTO, Italian Registry of Chronic Total Occlusions; LVEDV, left ventricular end diastolic volume; LVEF, left ventricular ejection fraction; MACCE, major adverse cardiac and cerebrovascular event; MACE, major adverse cardiac event; MI, myocardial infarction; MT, medical therapy; OMT, optimal medical treatment; OPEN‐CTO, Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures; PCI, percutaneous coronary intervention; STEMI, ST‐segment–elevation myocardial infarction; and TVR, target vessel revascularization.