Prevalence and management of coronary chronic total occlusions in a tertiary Veterans Affairs hospital.
Catheter Cardiovasc Interv
; 84(4): 637-43, 2014 Oct 01.
Article
em En
| MEDLINE
| ID: mdl-24142769
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ponte de Artéria Coronária
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United States Department of Veterans Affairs
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Oclusão Coronária
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Intervenção Coronária Percutânea
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Centros de Atenção Terciária
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Hospitais de Veteranos
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2014
Tipo de documento:
Article