Quality of Life After Percutaneous Coronary Intervention or Medical Therapy for Chronic Total Coronary Occlusions: EUROCTO and DECISION-CTO Meta-Analysis
Authors' conclusion
In this post-hoc analysis from 2 RCTs of patients with a single CTO and no significant concomitant lesion, PCI achieved better improvement in QoL, angina frequency, and the SAQ summary score than OMT with no signal of excess harm regarding clinical endpoints.
Study context
- Population
- Patients with a single CTO and no other significant coronary lesion
- Participants
- 518 patients · 2 RCTs
- Comparison
- Percutaneous coronary intervention (PCI) vs optimal medical therapy (OMT) for chronic total coronary occlusion
Methodological detailsEUROCTO and DECISION-CTO, intention-to-treat, Randomization 1:1 in DECISION and 2:1 in EUROCTO
- EUROCTO and DECISION-CTO
- Intention-to-treat
- Randomization 1:1 in DECISION and 2:1 in EUROCTO
Pooled result
As reported in the abstract
Change in SAQ scores from baseline · 12 months
| Group | Angina frequency change | Quality of life (QoL) change | Seattle Angina Questionnaire (SAQ) summary score change |
|---|---|---|---|
| PCI | 12.2 | 19.5 | 13.8 |
| OMT | 8.6 | 11.3 | 8.5 |
Angina frequency change
PCI12.2
OMT8.6
Quality of life (QoL) change
PCI19.5
OMT11.3
Seattle Angina Questionnaire (SAQ) summary score change
PCI13.8
OMT8.5
- PCI vs OMT: P = 0.009 — angina frequency
- PCI vs OMT: P < 0.001 — QoL
- PCI vs OMT: P < 0.001 — SAQ summary score
Further pooled results
Cardiac death or nonfatal MI · mean follow-up 3.1 years
P = 0.17
| Outcome | PCI | OMT | P value | |
|---|---|---|---|---|
| SAQ physical limitation · just at the level of the Bonferroni correction | P = 0.01 | |||
| Procedural success | 92.2% | Not reported in the abstract | OMT: not reported in the abstract |
Determinants of QoL improvement
- Low baseline score and assignment to PCI were the major determinants; gender, DM or lesion complexity had no influence
Safety
Target lesion revascularization · mean follow-up 3.1 years
P = 0.005
Target lesion revascularization · mean follow-up 3.1 years
- Stroke or hospitalization for bleeding similar
Original publication
Quality of Life After Percutaneous Coronary Intervention or Medical Therapy for Chronic Total Coronary Occlusions: EUROCTO and DECISION-CTO Meta-Analysis. J Am Coll Cardiol. Published 8 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it