Journal article
Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry
Journal of the American College of Cardiology, v 59(11), pp 991-997
13 Mar 2012
PMID: 22402070
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Abstract
The purpose of this study was to determine the prevalence, clinical characteristics, and management of coronary chronic total occlusions (CTOs) in current practice.
There is little evidence in contemporary literature concerning the prevalence, clinical characteristics, and treatment decisions regarding patients who have coronary CTOs identified during coronary angiography.
Consecutive patients undergoing nonurgent coronary angiography with CTO were prospectively identified at 3 Canadian sites from April 2008 to July 2009. Patients with previous coronary artery bypass graft surgery or presenting with acute ST-segment elevation myocardial infarction were excluded. Detailed baseline clinical, angiographic, electrocardiographic, and revascularization data were collected.
Chronic total occlusions were identified in 1,697 (18.4%) patients with significant coronary artery disease (>50% stenosis in ≥1 coronary artery) who were undergoing nonemergent angiography. Previous history of myocardial infarction was documented in 40% of study patients, with electrocardiographic evidence of Q waves corresponding to the CTO artery territory in only 26% of cases. Left ventricular function was normal in >50% of patients with CTO. Half the CTOs were located in the right coronary artery. Almost half the patients with CTO were treated medically, and 25% underwent coronary artery bypass graft surgery (CTO bypassed in 88%). Percutaneous coronary intervention was done in 30% of patients, although CTO lesions were attempted in only 10% (with 70% success rate).
Chronic total occlusions are common in contemporary catheterization laboratory practice. Prospective studies are needed to ascertain the benefits of treatment strategies of these complex patients.
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Details
- Title
- Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry
- Creators
- Paul Fefer - Health Sciences CentreMerril L Knudtson - Libin Cardiovascular Institute of AlbertaAsim N Cheema - St. Michael's HospitalP Diane Galbraith - Libin Cardiovascular Institute of AlbertaAzriel B Osherov - Health Sciences CentreSergey Yalonetsky - Health Sciences CentreSharon Gannot - Sheba Medical CenterMichelle Samuel - Health Sciences CentreMax Weisbrod - Health Sciences CentreDaniel Bierstone - Health Sciences CentreJohn D Sparkes - Health Sciences CentreGraham A Wright - Health Sciences CentreBradley H Strauss - Health Sciences Centre
- Publication Details
- Journal of the American College of Cardiology, v 59(11), pp 991-997
- Grant note
- CTP 82943 / Canadian Institutes of Health Research
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000301222700005
- Scopus ID
- 2-s2.0-84857857544
- Other Identifier
- 991022135714504721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems