Coronary chronic total occlusions were highly prevalent in veterans with CAD (89% with prior CABG, 31% without), and PCI was performed similarly in patients with and without CTO (50% vs 53%).
Observational (n=1,699)
No
What is the prevalence and management of coronary chronic total occlusions in a veteran population undergoing coronary angiography?
Coronary CTOs are highly prevalent in veterans undergoing angiography, especially those with prior CABG, and are associated with more comorbidities and CABG referrals, though CTO PCI can be performed with high success rates.
Absolute Event Rate: 50% vs 53%
OBJECTIVES: We sought to determine the contemporary prevalence and management of coronary chronic total occlusions (CTO) in a veteran population. BACKGROUND: The prevalence and management of CTOs in various populations has received limited study. METHODS: We collected clinical and angiographic data in consecutive patients that underwent coronary angiography at our institution between January 2011 and December 2012. Coronary artery disease (CAD) was defined as ≥50% diameter stenosis in ≥1 coronary artery. CTO was defined as total coronary artery occlusion of ≥3 month duration. RESULTS: Among 1,699 patients who underwent angiography during the study period, 20% did not have CAD, 20% had CAD and prior coronary artery bypass graft surgery (CABG), and 60% had CAD but no prior CABG. The prevalence of CTO among CAD patients with and without prior CABG was 89 and 31%, respectively. Compared to patients without CTO, CTO patients had more co-morbidities, more extensive CAD and were more frequently referred for CABG. Percutaneous coronary intervention (PCI) to any vessel was performed with similar frequency in patients with and without CTO (50% vs. 53%). CTO PCI was performed in 30% of patients without and 15% of patients with prior CABG with high technical (82 and 75%, respectively) and procedural success rates (80 and 73%, respectively). CONCLUSIONS: In a contemporary veteran population, coronary CTOs are highly prevalent and are associated with more extensive co-morbidities and higher likelihood for CABG referral. PCI was equally likely to be performed in patients with and without CTO.
Jeroudi et al. (Sat,) conducted a observational in Coronary chronic total occlusions (n=1,699). Coronary chronic total occlusion (CTO) vs. No CTO was evaluated on Percutaneous coronary intervention (PCI) to any vessel. Coronary chronic total occlusions were highly prevalent in veterans with CAD (89% with prior CABG, 31% without), and PCI was performed similarly in patients with and without CTO (50% vs 53%).