Prevalence and management of coronary chronic total occlusions in a tertiary Veterans Affairs hospital
- PMID: 24142769
- PMCID: PMC3992199
- DOI: 10.1002/ccd.25264
Prevalence and management of coronary chronic total occlusions in a tertiary Veterans Affairs hospital
Abstract
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.
Keywords: coronary artery disease; coronary occlusion; percutaneous coronary intervention.
Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
Figures
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Comment in
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Are veterans and the VA any more "crusty" than others?Catheter Cardiovasc Interv. 2014 Oct 1;84(4):644-5. doi: 10.1002/ccd.25641. Catheter Cardiovasc Interv. 2014. PMID: 25251709 No abstract available.
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