Clinical characteristics and treatment outcomes of patients with MDR tuberculosis in Dar Es Salaam region, Tanzania

Abstract Background In Tanzania more than 28% of all multi-drug resistant tuberculosis (MDR-TB) cases occur in Dar es Salaam. However, information about management and clinical outcomes of patients with MDR-TB in the region is scarce, and hence the need for this study. Methods A 5-year retrospective cohort study was conducted in six centres in Dar es Salaam. Descriptive statistics were used to summarize social demographics and clinical characteristics. Associations between occurrence of adverse events, regimen change and cure were determined using the Chi-square test whereas factors associated with mortality were determined using the Log-ranking test and Cox regression model. Results Three-hundred patient files were found and reviewed. The majority were male 199 (66.3%), aged 25–44 years [176 (58.7%)] and 89 (30.1%) were HIV co-infected. 186 (62%) completed their treatment, 68 (22.0%) were on treatment and 9 (3.3%) were lost to follow-up. The majority, 152 (51.0%) were managed using long MDR-TB regimens. The overall mortality rate was 5.7 per 1000 MDR-TB patients. A higher mortality rate was associated with being ≥45 years [adjusted hazard ratio (AHR): 10.82, 95% CI: 1.14–102.74, P = 0.038), female (AHR: 5.92, 95% CI: 1.75–20.08, P = 0.004), on a short anti-TB regimen (AHR: 4.34, 95% CI: 1.41–13.35, P = 0.010), HIV co-infected [crude hazard ratio (CHR): 2.56, 95% CI: 1.01–6.50, P = 0.048), on concomitant long-term medication use (CHR: 2.99, 95% CI: 1.17–7.64, P = 0.022) and having other co-morbidities (CHR: 3.45, 95% CI: 1.32–9.02, P = 0.011). Conclusions MDR-TB mortality was associated with short anti-TB regimens, sex, age, concomitant long-term medication use and HIV coinfection. In this population, use of long and individualized regimens is recommended.

Download Full-text

Clinical Characteristics And Analysis Of Risk Factors For Disease Progression Of COVID-19 Among Patients Within Wad Medani Isolation Centers, Gezira State: A Prospective Cohort Study From Sudan

10.21203/rs.3.rs-967313/v1 ◽

2021 ◽

Author(s):

Mohammed Yousif Elnaeem Yousif ◽

Moh.Mah.Fadel Allah Eljack ◽

Osman Amir ◽

Mohammed Alfatih ◽

Akram Khalid Al Tigany Al Shiekh ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Mortality Rate ◽

Clinical Characteristics ◽

Severe Disease ◽

Severe Infection ◽

Chi Square ◽

Factors Associated ◽

Glucose Levels ◽

Chi Square Test

Abstract Background : (COVID-19) had a great impact on the world’s health systems since December 2019. A little is known about the clinical characteristics and risk factors associated with COVID-19 severity in Sudanese Patients; therefor it is necessary to summarize the clinical characteristics of patients with COVID-19 and to explore the risk factors associated with COVID-19 severity. Methods : A one-year retrospective cohort study (May 2020- May2021) was done at three isolation centers in Wad Medani. Sample contained all COVID-19 patients who are over 18 years old and were confirmed to be COVID-19 by nucleic acid testing or features Suggestive of Covid19 on Chest CT scan. Results : This study included 418 patients confirmed COVID-19 cases with a median age of 66.3±13years. 179 (64.2%) patients were men. Hypertension (n=195; 46.7%) and diabetes (n=187; 44.7%) were the most common comorbidities. The most common symptoms at COVID-19 onset were fever (n=303; 72.5%), cough (n=278; 66.5%) and dyspnea (n= 256; 61.2%). the overall mortality rate was 35.4% (n=148). The morality rate was 42.3% (n=118) among patients with severe disease. The Chi-square test and ANOVA analysis revealed that older age, anemia, neutrophilia and lymphcytopenia, higher glucose levels, HbA1c levels and creatinine levels were variables associated with severe COVID-19. In inflammatory markers, the levels of CRP and d-dimer were elevated in severe infection more than moderate and mild infections. Conclusion : Patients with these factors are more likely to deteriorate into severe infection and have higher mortality rate than those without these factors.

Download Full-text

Thyroid Complications Negatively Affect Therapeutic Response and Survival in Waldenstrom Macroglobulinaemia/ Lymphoplasmacytoid Lymphoma

Blood ◽

10.1182/blood-2021-149677 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 4513-4513

Author(s):

Xinting Hu ◽

Hua Wang ◽

Hongzhi Xu ◽

Xin Liu ◽

Ying Li ◽

...

Keyword(s):

Gene Expression ◽

Clinical Characteristics ◽

Cox Regression ◽

Statistical Significance ◽

Progression Free Survival ◽

Chi Square ◽

Free Survival ◽

Kaplan Meier ◽

Chi Square Test

Abstract Introduction: Waldenström macroglobulinaemia/ Lymphoplasmacytoid lymphoma (WM/LPL) is a rare lymphoproliferative neoplasm characterized by small B lymphocytes proliferation. Abnormalities of thyroid hormones are common in clinical courses. Yet, the role of thyroid complications has not been explored in WM/LPL. Hence, the aim of this study was to investigate the clinical significance of thyroid complications in WM/LPL. Methods: 105 clinically diagnostic WM/LPL patients from Shandong Provincial Hospital were enrolled with informed consents. Baseline and clinical data concerning sex, age, International Staging System Waldenstrom Macroglobulinemia (ISSWM) score et al were collected. Chi-square test was used for comparison of clinical characteristics. The Kaplan-Meier method was used for analysis of survival outcomes. Cox regression analyses were utilized to identify prognostic-related key factors associated with overall survival (OS) and progression-free survival (PFS) in WM/LPL patients. Microarray datasets GSE6691 were obtained from Gene Expression Omnibus. Results: Over the 105 WM/LPL patients, the median overall survival (OS) was not reached and median progression-free survival (PFS) was 96 months (Figure 1A, 1B). Patients classified as complete response (CR)/ partial response (PR)/ stable disease (SD), showed better OS and PFS than patients with progression disease (PD) (Figure 1C, D). There were 13.3% of enrolled patients with mixed thyroid complications. The results of Chi-square test showed that thyroid complications were significantly associated with reduced IgM level (p=0.036) and elevated β2-macroglobulin (p=0.032). Moreover, patients without thyroid comorbidities were more likely to get overall response (CR+PR) to the first-line treatment (p=0.004). Kaplan-Meier curves showed patients with thyroid complications had significantly shorter OS (p=0.02) and PFS (p<0.001) versus those without thyroid complications (Figure 1E, F). In the univariate Cox regression model, age (p=0.022), ISSWM score (p=0.014) and thyroid complications (p<0.001) were significantly associated with an increased risk of progression developed. Subsequent multivariate analysis showed the presence of thyroid complications was an independent prognostic indicator for PFS in WM/LPL patients (p=0.03). However, there was no statistical significance of thyroid complications in OS. Microarray dataset analysis was conducted to further investigate the role of thyroid-related genes in WM/LPL patients. A network of interactions among thyroid-related genes and critical factors in WM/LPL, including MYD88 and CXCR4, was shown in Figure 1G. Correlations were statistically significant between SLC5A5 (p<0.05), TG (p<0.01), TPO (p<0.01) and CXCR4 by Spearman correlation analysis (Figure 1H, I). In addition, differential gene expression analysis between the WM and normal lymphocytes was assessed (Figure 1J). Thyroid-related genes with statistical significance were annotated in the volcano plots (Figure 1K). Enrichment analysis indicated that differential genes were involving in PI3K-Akt signaling pathway and response to peptide hormone (Figure 1L). Moreover, five of them reached statistical significance, illuminating the potential importance of thyroid-related genes in WM/LPL (Figure 1M). Conclusion: Taken together, the present study was the first investigation on the role of thyroid complications in WM/LPL. Patients with thyroid complications showed worse clinical characteristics and conferred independent prognostic significance. The primary strength of this study is that it provides robust real-world evidence on the prognostic role of thyroid complications, highlighting the need to monitor and appropriately manage WM/LPL patients with thyroid complications in medical admissions. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Download Full-text

Prognostic Analysis and Clinical Characteristics of Dual Primary Lung Cancer: A Population Study Based on Surveillance, Epidemiology, and End Results (SEER) Database

10.21203/rs.3.rs-705632/v1 ◽

2021 ◽

Author(s):

Guanghui Wang ◽

Yukai Zeng ◽

Haotian Zheng ◽

Xiaogang Zhao ◽

Yadong Wang ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factors ◽

Clinical Characteristics ◽

Prognostic Model ◽

Cox Regression ◽

Primary Lung Cancer ◽

Chi Square ◽

Training Cohort ◽

Cox Regression Analysis ◽

Chi Square Test

Abstract Background: The peculiarity and the lack of clinical studies of dual primary lung cancer (DPLC) led to limited knowledge about its clinical characteristics and prognosis. The current study performed a retrospective analysis and established a prognostic nomogram to assess the prognostic factors and clinical characteristics of DPLC.Methods: A total of 1419 DPLC patients with pathological confirmation from SEER were selected and analyzed by univariate and multivariable Cox regression analyses. The independent prognostic factors were included to establish a nomogram. The accuracy and reliability of prognostic model were evaluated by C-indexes, calibration plots, receiver operating characteristic (ROC) curves, decision curve analyses (DCA) and integrated discrimination improvement (IDI) scores. Chi-square test was used to assess the differences between DPLC and single primary lung cancer (SPLC) or synchronous DPLC (sDPLC) and metachronous DPLC (mDPLC).Results: Cox regression analysis showed that age, sex, histological type, stage, LN metastasis, surgery, chemotherapy were independent prognostic factors, we included these factors to establish a prognostic model. In the training cohort, the C-index was 0.690, and the area under curves (AUC) of 3- and 5-year survival time were 0.720 and 0.723. The calibration plots in training cohort and validation cohort were in excellent agreement. DCA and IDI showed that the predictive effect of the novel prognostic model was better than the model based on 8th AJCC TNM system. Chi-square test indicated that DPLC and SPLC had statistical differences on pathological and clinical features.Conclusions: The clinical and pathological characteristics of DPLC were different from the SPLC. The nomogram based on significant factors could provide accurate and individualized survival predictions for DPLC.

Download Full-text

Characteristics, outcome and predictors of in-hospital mortality in an elderly population from a SARS-CoV-2 outbreak in a long-term care facility

10.1101/2020.06.30.20143701 ◽

2020 ◽

Cited By ~ 3

Author(s):

Enrico Maria Trecarichi ◽

Maria Mazzitelli ◽

Francesca Serapide ◽

Maria Chiara Pelle ◽

Bruno Tassone ◽

...

Keyword(s):

Mortality Rate ◽

Hospital Mortality ◽

Clinical Characteristics ◽

Long Term Care ◽

Cox Regression ◽

Care Facility ◽

Serum Levels ◽

Term Care ◽

Long Term Care Facility

AbstractSince December 2019, coronavirus disease 2019 (COVID-19) pandemic has spread from China all over the world, many COVID-19 outbreaks have been reported in long-term care facilities (LCTF). However, data on clinical characteristics and prognostic factors in such settings are scarce. We conducted a retrospective, observational cohort study to assess clinical characteristics and baseline predictors of mortality of COVID-19 patients hospitalized after an outbreak of SARS-CoV-2 infection in a LTCF.A total of 50 patients were included. Mean age was 80 years (SD, 12 years), and 24/50 (57.1%) patients were males. A total of 42/50 (84%) patients experienced symptoms of SARS-CoV-2 infection. The overall in-hospital mortality rate was 32%. In Cox regression, significant predictors of in-hospital mortality were: hypernatremia (HR 9.12), lymphocyte count <1000 cells/µL (HR 7.45), cardiovascular diseases other than hypertension (HR 6.41), and higher levels of serum interleukin-6 (IL-6, pg/mL) (HR 1.005).Our study shows a high in-hospital mortality rate in a cohort of elderly patients with COVID-19 and hypernatremia, lymphopenia, CVD other than hypertension, and higher IL-6 serum levels were identified as independent predictors of in-hospital mortality. Further studies are necessary to better understand and confirm our findings in the setting of a LTCF outbreak of COVID-19.

Download Full-text

KORELASI ANTARA HASIL TES MIKROSKOPIS DENGAN TES CEPAT MOLEKULER PADA PASIEN TUBERCULOSIS DAN MULTIDRUG RESISTEN TUBERCULOSIS DI RSUD Dr. H CHASAN BOESOIRIE TERNATE

Kieraha Medical Journal ◽

10.33387/kmj.v2i1.2324 ◽

2020 ◽

Vol 2 (1) ◽

Author(s):

Andi Sitti Nur Afiah ◽

Fera The

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Disease ◽

Program Analysis ◽

Rifampicin Resistance ◽

Test Results ◽

Chi Square ◽

Significant Difference ◽

Mdr Tb ◽

Chi Square Test ◽

Analytical Research

Tuberculosis (TB) is a pulmonary disease caused by Mycobacterium tuberculosis. Globally in 2018 theestimated number of people affected by TB was estimated at 10.0 million population and 484,000 cases ofmultidrug-resistant TB (MDR-TB). This study aims to determine the correlation between microscopic testresults with RMT on TB and MDR-TB patients at RSUD Dr. H Chasan Boesoirie Ternate. This type of researchis analytical research using a retrospective approach. The sample in this study were patients with suspected TBand MDR-TB who had performed microscopic tests and TCM in February – April at 2020 in the ClinicalPathology Laboratory of RSUD Dr. H Chasan Boesoirie Ternate, who met the inclusion and exclusion criteria.Data were analyzed using the SPSS program analysis was carried out in stages, namely by univariate andbivariate using chi-square test. From 100 samples, the results of RMT examination with TB suspects were 30rifampicin sensitive samples with 2 rifampicin resistance and 5 rifampin sensitive samples for TB MDR-TBsuspects RMT examination results. Chi-square test results obtained the value of p = 000 (p <0.05). There is stilla significant difference between the microscopic test results with RMT in TB and MDR-TB suspect patients atRSUD Dr. H Chasan Boesoirie Ternate.

Download Full-text

Long-Term Outcomes and Causes of Death among Medullary Thyroid Carcinoma Patients with Distant Metastases

Cancers ◽

10.3390/cancers13184670 ◽

2021 ◽

Vol 13 (18) ◽

pp. 4670

Author(s):

Hyunju Park ◽

Heera Yang ◽

Jung Heo ◽

Tae Hyuk Kim ◽

Sun Wook Kim ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Medullary Thyroid Carcinoma ◽

Distant Metastasis ◽

Clinical Characteristics ◽

Causes Of Death ◽

Hazard Ratio ◽

Poor Prognostic Factor ◽

Medullary Thyroid ◽

Metastatic Site

Distant metastasis is a poor prognostic factor in medullary thyroid carcinoma (MTC), but the significance of differentiating the characteristics according to the site of distant metastasis remains unclear. This study aimed to evaluate the clinical characteristics and long-term oncologic outcomes in MTC patients with distant metastasis. We identified 46 MTC patients with distant metastasis between 1994 and 2019. Clinical characteristics were compared based on the timing of the detection of distant metastasis. Additionally, survival rates following the detection of distant metastasis were evaluated to compare the clinical significance of metastatic site. The detailed causes of death were also investigated. Of the 46 patients, 15 patients (32.6%) had synchronous distant metastasis and 31 patients (67.4%) had metachronous distant metastasis. There was no clinical difference between these two groups except regarding initial surgical extent. The lung (52.2%) was the most common metastatic site, followed by the bone (28.3%), mediastinum (19.6%), liver (17.4%), adrenal gland (4.3%), brain (4.3%), kidney (2.2%), and pancreas (2.2%). Patients with bone metastasis and multisite metastasis had significantly worse prognoses than those with lung metastasis (hazard ratio: 5.42; p = 0.044 and hazard ratio: 6.11; p = 0.006). Complications due to the progression of distant metastasis, airway obstruction due to tracheal invasion, and complications related to chemotherapy were leading causes of death. In conclusion, there was no difference in clinical characteristics according to the timing of distant metastasis. Oncological outcomes differed by metastatic site.

Download Full-text

Clinical and Demographic Predictors of Mortality due to COVID-19 Pandemic: A Retrospective Study

International Journal of Health Sciences and Research ◽

10.52403/ijhsr.20210511 ◽

2021 ◽

Vol 11 (5) ◽

pp. 74-81

Author(s):

Ayushi Rajkumar Jain ◽

Doss Prakash ◽

Sheetal Swamy

Keyword(s):

Risk Factors ◽

Mortality Rate ◽

Early Stage ◽

Major Complication ◽

Respiratory Arrest ◽

Chi Square ◽

High Risk Factors ◽

Demographic Predictors ◽

Chi Square Test ◽

The Common

The alarming statistics of COVID-19 surges up in 2021 throwing an enormous burden on the healthcare system across the world. According to WHO reports on 14th April 2021, globally 136,996,364 confirmed COVID-19 cases are reported across the continents, including 2,951,832 deaths. The state of Maharashtra reported the maximum number of cases of India including high mortality rate. This study was conducted to identify and describe the relation of different predictors (Age, gender, duration of hospital stay, presence of co morbidities) of mortality among the COVID-19 deceased patients by retrospectively analyzing the medical case records of 121 patients from a dedicated COVID hospital at Aurangabad from July 2020 to December 2020. Chi-square test was performed to assess the association between causes of death with different cluster of variables and their significance. This study helps us to identify risk factors that show association between various predictors and mortality rate in COVID-19 patients. Out of 121 deaths, 96 (79%) were male, 61 (49.6%) were in age group between 60-79 years, ARDS was one of the major complication in the deceased patients accounting 29.8% and cardio respiratory arrest was the common cause of death among the deceased patients with 85%. It was also observed that mortality rate was very higher in the initial five days of hospitalization with critical care support. Our result findings provide clinical inferences for physicians to identify high-risk factors with COVID-19 at a very early stage. Key words: COVID-19, Mortality rate, Demographic predictors, Co-morbidities, Cardio respiratory arrest.

Download Full-text

CIP4 Expression is Associated With The Prognosis in Colorectal Cancer

10.21203/rs.3.rs-95046/v1 ◽

2020 ◽

Author(s):

Keqian Zhang ◽

Tianqi Mao ◽

Zhicheng He ◽

Xiaojiao Wu ◽

Yu Peng ◽

...

Keyword(s):

Colorectal Cancer ◽

Cox Regression ◽

Prognostic Significance ◽

Lymphatic Invasion ◽

Chi Square ◽

Interacting Protein ◽

Cox Regression Analysis ◽

Kaplan Meier ◽

Chi Square Test ◽

Student’S T

Abstract Background: This study was conducted to detect the expression of Cdc42 interacting protein 4 (CIP4) in patients with colorectal cancer (CRC), and explore the role of CIP4 in prognosis of CRC patients.Methods: The expression of CIP4 mRNA was determined by quantitative real-time PCR (qRT-CPR) and compared by student’s t-test between groups. Relationships of clinical characteristics and CIP4 expression were analyzed by Chi-square test. Kaplan-Meier curves were used to estimate the overall survival of CRC patients. And Cox regression analysis was conducted to identify the prognostic biomarkers for CRC patients.Results: The qRT-PCR results showed that CRC tissues were detected with significantly high CIP4 mRNA expression compared with adjacent normal controls (P<0.0001). The overexpression of CIP4 in CRC tissues was influenced by distant metastasis (P=0.021), lymphatic invasion (P=0.012) and TNM stage (P=0.006). But, other clinical factors including age, gender, differentiation and tumor site were proved to have no obvious effects on CIP4 expression (all, P>0.05). The survival curves showed that patients with high CIP4 expression generally lived shorter than those with low CIP4 expression (P<0.001). In addition, the multivariate analysis revealed that differentiation (P=0.044, HR=1.631, 95%CI=1.013-2.626) and CIP4 expression (P=0.000, HR=5.283, 95%CI=3.138-8.893) were of great prognostic significance for CRC patients.Conclusion: Taken together, up-regulation of CIP4 in CRC tissues represented poor prognosis for patients.

Download Full-text

Preadmission Statin Use and 90-day Mortality in the Critically Ill

Anesthesiology ◽

10.1097/aln.0000000000002811 ◽

2019 ◽

Vol 131 (2) ◽

pp. 315-327 ◽

Cited By ~ 1

Author(s):

Tak Kyu Oh ◽

In-Ae Song ◽

Jae Ho Lee ◽

Cheong Lim ◽

Young-Tae Jeon ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Mortality Rate ◽

Critically Ill ◽

Cox Regression ◽

Hazard Ratio ◽

Cox Regression Analysis ◽

Statin Dose ◽

Mortality Hazard Ratio ◽

Statin Use

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background This study aimed to examine the association between preadmission statin use and 90-day mortality in critically ill patients and to investigate whether this association differed according to statin type and dose. We hypothesized that preadmission statin use was associated with lower 90-day mortality. Methods This retrospective cohort study analyzed the medical records of all adult patients admitted to the intensive care unit in a single tertiary academic hospital between January 2012 and December 2017. Data including preadmission statin use, statin subtype, and daily dosage were collected, and the associations between these variables and 90-day mortality after intensive care unit admission were examined. The primary endpoint was 90-day mortality. Results A total of 24,928 patients (7,396 statin users and 17,532 non–statin users) were included. After propensity score matching, 5,354 statin users and 7,758 non–statin users were finally included. The 90-day mortality rate was significantly higher in non–statin users (918 of 7,758; 11.8%) than in statin users (455 of 5,354; 8.5%; P < 0.001). In Cox regression analysis, the 90-day mortality rate was lower among statin users than among non–statin users (hazard ratio: 0.70, 95% CI: 0.63 to 0.79; P < 0.001). Rosuvastatin use was associated with 42% lower 90-day mortality (hazard ratio: 0.58, 95% CI: 0.47 to 0.72; P < 0.001). There were no specific significant differences in the association between daily statin dose and 90-day mortality. In competing risk analysis, the risk of noncardiovascular 90-day mortality in statin users was 32% lower than that in non–statin users (hazard ratio: 0.68, 95% CI: 0.60 to 0.78; P < 0.001). Meanwhile, cardiovascular 90-day mortality was not significantly associated with statin use. Conclusions Preadmission statin use was associated with a lower 90-day mortality. This association was more evident in the rosuvastatin group and with noncardiovascular 90-day mortality; no differences were seen according to daily dosage intensity.

Download Full-text

124Impact of intimal tracking for recanalization of CTO lesions on long-term clinical outcomes

European Heart Journal ◽

10.1093/eurheartj/ehz747.0040 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Kano ◽

K Nasu ◽

M Habara ◽

T Shimura ◽

M Yamamoto ◽

...

Keyword(s):

Clinical Outcomes ◽

Cox Regression ◽

Target Lesion ◽

Hazard Ratio ◽

Rank Test ◽

Total Occlusion ◽

Significant Difference ◽

The Impact

Abstract Background For recanalization of coronary chronic total occlusion (CTO) lesions, subintimal guidewire tracking in both antegrade and retrograde approaches are commonly used. Purpose This study aimed to assess the impact of subintimal tracking on long-term clinical outcomes after recanalization of CTO lesions. Methods Between January 2009 and December 2016, 474 CTO lesions (434patients) were successfully recanalized in our center. After guidewire crossing in a CTO lesion, those lesions were divided into intimal tracking group (84.6%, n=401) and subintimal tracking group (15.4%, n=73) according to intravascular ultrasound (IVUS) findings. Long-term clinical outcomes including death, target lesion revascularization (TLR), target vessel revascularization (TVR) were compared between the two groups. In addition, the rate of re-occlusion after successful revascularization was also evaluated. Results The median follow-up period was 4.7 years (interquartile range, 2.8–6.1). There was no significant difference of the rate of cardiac death between the two groups (intimal tracking vs. subintimal tracking: 7.0% vs. 4.1%; hazard ratio, 0.61; 95% confidence interval [CI], 0.19 to 2.00; p=0.41), TLR (14.3% vs. 16.2%; hazard ratio, 1.34; 95% CI, 0.71 to 2.53; p=0.37), and TVR (17.5% vs. 20.3%; hazard ratio, 1.27; 95% CI, 0.72 to 2.23; p=0.42). However, the rate of re-occlusion was significantly higher in the subintimal tracking group than intimal tracking group at 3-years re-occlusion (4.2% vs. 14.5%; log-rank test, p=0.002, Figure). In the multivariate COX regression, subintimal guidewire tracking was an independent predictor of re-occlusion after CTO recanalization (HR: 5.40; 95% CI: 2.11–13.80; p<0.001). Figure 1 Conclusions Subintimal guidewire tracking for recanalization of coronary CTO was associated with significantly higher incidence of target lesion re-occlusion during long-term follow-up period.

Download Full-text