Stahli BE, et al. – The link between atrial fibrillation and outcomes following percutaneous coronary intervention (PCI) for chronic total occlusions (CTO), was assessed in this present investigation. Findings demonstrated an independent association of atrial fibrillation with mortality post–CTO PCI. In addition, data also highlighted a substantial survival benefit of successful CTO recanalization in both patients with and without atrial fibrillation.

Methods

• In this study, researchers divided consecutive patients undergoing CTO PCI between January 2005 and December 2013 into patients with and without atrial fibrillation, and used propensity-matched models to adjust for baseline differences between groups.
• The primary outcome was all-cause mortality at a median follow-up of 3.2 (interquartile range 3.1–4.5) years.

Results

• As per findings, out of 2002 patients undergoing CTO PCI, atrial fibrillation was present in 169 (8.4%) patients.
• Researchers observed that patients with atrial fibrillation were older, and more frequently had hypertension, left ventricular systolic dysfunction, and chronic kidney disease.
• They also noted that before matching, all-cause mortality was 39.6 and 14.5% in the atrial fibrillation and the sinus rhythm groups (HR 2.92, 95% CI 2.23–3.82, p < 0.001).
• In the propensity-matched model, it was demonstrated that atrial fibrillation remained associated with an increased risk of mortality (HR 1.62, 95% CI 1.06–2.47, p = 0.03).
• In the unmatched patient cohort, researchers found that all-cause mortality was significantly reduced in patients with procedural success, both in the atrial fibrillation (34.9 versus 55.0%, adjusted HR 0.99, 95% CI 0.97–1.00, p = 0.02) and the sinus rhythm groups (12.8 versus 23.0%, adjusted HR 0.70, 95% CI 0.53–0.92, p = 0.01).