Can History of Myocardial Infarction Reliably Indicate Myocardial Viability in Patients With a Coronary Chronic Total Occlusion and Good Collateral Circulation?

J Invasive Cardiol. 2021 Feb;33(2):E135.


We read with interest the study by Shaikh et al reporting that none of the patients with coronary chronic total occlusions (CTOs) and a prior Q-wave myocardial infarction (MI) in the CTO-supplied territory had viable myocardium even in the presence of good collateral circulation. Based on our large, multicenter registry on CTO in percutaneous coronary intervention, PROGRESS-CTO, we believe viability testing may still be of value in patients with a CTO and a prior MI, especially if their ejection fraction is low and dyspnea is the predominant symptom.

Keywords: chronic total occlusion; clinical outcomes.

Publication types

  • Letter
  • Comment

MeSH terms

  • Collateral Circulation
  • Coronary Angiography
  • Coronary Occlusion* / complications
  • Coronary Occlusion* / diagnosis
  • Coronary Occlusion* / surgery
  • Humans
  • Myocardial Infarction* / diagnosis
  • Myocardium
  • Percutaneous Coronary Intervention*