Abstract 20015: Clinical Presentation of Patients Undergoing Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry
Introduction: We examined the clinical presentation of patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a multicenter registry.
Methods: The baseline clinical and angiographic characteristics and procedural outcomes of 1,268 patients who underwent CTO PCI between 2012 and 2016 at 12 US centers were analyzed.
Results: The study population was divided to 5 groups based on the clinical presentation of CTOs: stable angina (59.0%), unstable angina (21.9%), ST-segment-elevation acute myocardial infarction (STEMI, 1.5%), non-ST segment elevation acute myocardial infarction (NSTEMI, 6.4%), symptoms unlikely to be ischemic or no symptoms (11.2%). Mean age was 65.7 ± 10 years and 86% were men. NSTEMI patients were more likely to have diabetes mellitus (63%, p=0.020) and patients presenting with STEMI had the lowest left ventricular ejection fraction (43 ± 20%, p<.0001). Patients presenting with unstable angina were more complex, had more calcified lesions (64%, p=0.002), more ambiguous proximal cap (41%, p=0.002) and the highest J-CTO scores (2.90 ± 1.20, p=0.0002). Also patients with unstable angina had the longest fluoroscopy time (55 [33, 83] min, p<.0001), but air kerma radiation doses and contrast volume were similar among groups. In-hospital technical and procedural success and major cardiac adverse event rates were similar between groups (Figure 1).
Conclusions: Most patients undergoing CTO PCI present with stable angina, although approximately 1 in 4 present with an acute coronary syndrome. Technical and procedural success and the incidence of major cardiac adverse events were high and similar among study groups.
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- © 2016 by American Heart Association, Inc.