No Significant Difference Between Initial CTO-PCI and No CTO-PCI Strategies in 10-Year Follow-Up

In the 10-year extended follow-up of the DECISION-CTO trial, an initial strategy of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) was not associated with a significant difference in the primary composite endpoint of death, myocardial infarction, stroke, or any revascularization compared with a no CTO-PCI strategy (33.9% vs 37.4%), and all-cause mortality also did not differ significantly between groups (12.7% vs 16.5%; HR: 0.76). The trial randomized 834 patients across 19 centers in 5 Asian countries, with 804 included in the modified intention-to-treat analysis (413 CTO-PCI, 391 no CTO-PCI) and 10-year clinical follow-up complete in 688 patients (85.6%); restricted mean event-free survival time at 10 years was similarly comparable (7.52 vs 7.53 years). However, wide confidence intervals preclude definitive conclusions regarding the potential benefit or harm of an initial CTO-PCI strategy. Source: https://www.jacc.org/