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ExploreTrial

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EXPLORE COMPLETED!!!!

304 patients enrolled!

Impact of CTO on LVF

Additionally, we investigated the effect of a CTO on left ventricular ejection fraction (LVEF) in patients who received an echocardiography after PPCI. As you can see in the next figure, patients with a CTO more often had a LVEF of 40% or lower in comparison to the other two groups. There was no significant difference between the groups with SVD and MVD without a CTO.

Figure 7: Proportion of STEMI patients with a LVEF ≤ 40% after PPCI for STEMI. 

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                 Claessen BE, JACC Cardiovasc Interv. 2009 Nov;2(11):1128-34.


During the first year follow-up, it seems that patients with a CTO had a stronger reduction in their LVEF in comparison to the other two groups, see next figure.


Figure 8: Proportion of STEMI patients with a further reduction of LVEF during the first follow-up year.

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                Claessen BE, JACC Cardiovasc Interv. 2009 Nov;2(11):1128-34.

The proportion of CS patients with a LVEF ≤ 40% was 24% for SVD, 44% for MVD without a CTO and 42% for MVD with a CTO.  In patients without CS, MVD with a coexisting CTO was more often associated with LVEF ≤ 40% in comparison to patients with MVD without a CTO or SVD whereas in patients with CS, MVD with and without a CTO were both more often associated with LVEF ≤ 40% in comparison to patients with SVD.

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After evaluation of the abovementioned data, we can conclude that the presence of a CTO drives mortality in STEMI patients with MVD and is associated with a reduced LVEF and a further reduction of LVEF. 

This data has lead us to the explore trial, which will investigate the effect of CTO revascularization within the first week, on left ventricular function.