Prevalence and correlated factors for chronic total occlusion in patients with coronary artery disease in Iraqi Kurdistan

Submitted: 25 October 2021
Accepted: 15 February 2022
Published: 16 March 2022
Abstract Views: 650
PDF: 141
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Patients with significant coronary artery disease often have at least one vessel with Chronic Total Occlusion (CTO) as demonstrated by coronary angiography. However, the prevalence and determinants of CTO differ according to ethnicity. We aimed to investigate the prevalence and determinants of CTO in the Iraqi Kurdistan population in 2015. Clinical and angiographic data were collected in consecutive patients that underwent coronary angiography at our institution between January and December 2015. Coronary artery disease (CAD) was determined as 50% diameter stenosis in one coronary artery and CTO as total coronary artery occlusion of 3-month duration. Among 260 patients diagnosed with ischemic coronary artery disease and undergone coronary angiography, 28.5% (n=74) were diagnosed to have at least one CTO vessel and 69 (26.5%) patients had a previous history of myocardial infarction. CTOs were located in the left anterior descending coronary artery in 45% of patients while in the right coronary artery in 32%. CTO patients were substantially older (61 vs 56 years; p <0.0001) and more likely to live in non-urban areas. They frequently had more hypertension, dyslipidemia, diabetes mellitus, previous myocardial revascularization, being an exsmoker, and renal dysfunction as compared to patients without CTOs. At univariate analysis, a previous history of coronary artery bypass graft (CABG) surgery was the only predictor of having a diagnosis of CTO. Patients diagnosed with CTO in Iraqi Kurdistan had several comorbidities including cardiovascular risk factors and renal dysfunction. Previous CABG was the only predictor of CTO diagnosis.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Fefer P, Knudtson ML, Cheema AN, et al. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol 2012;59:991-97. DOI: https://doi.org/10.1016/j.jacc.2011.12.007
Jeroudi OM, Alomar ME, Michael TT, et al. Prevalence and management of coronary chronic total occlusions in a tertiary Veterans Affairs hospital. Catheterization Cardiovascular Interv 2014;84:637-43. DOI: https://doi.org/10.1002/ccd.25264
Christofferson RD, Lehmann KG, Martin GV, et al. Effect of chronic total coronary occlusion on treatment strategy. Am J Cardiol 2005;95:1088-91. DOI: https://doi.org/10.1016/j.amjcard.2004.12.065
Werner GS, Gitt AK, Zeymer U, et al. Chronic total coronary occlusions in patients with stable angina pectoris: impact on therapy and outcome in present day clinical practice. Clin Res Cardiol 2009;98:435-41. DOI: https://doi.org/10.1007/s00392-009-0013-5
Ito T, Tsuchikane E, Nasu K, et al. Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study. Eur Radiol 2015;25:3084-92. DOI: https://doi.org/10.1007/s00330-015-3706-3
Michael TT, Karmpaliotis D, Brilakis ES, et al. Impact of prior coronary artery bypass graft surgery on chronic total occlusion revascularisation: insights from a multicentre US registry. Heart 2013:heartjnl-2013-303763. DOI: https://doi.org/10.1136/heartjnl-2013-303763
Hamur H, Onk OA, Vuruskan E, et al. Determinants of chronic total occlusion in patients with peripheral arterial occlusive disease. Angiology 2017;68:151-58. DOI: https://doi.org/10.1177/0003319716641827
Brilakis ES, Banerjee S, Karmpaliotis D, et al. Procedural outcomes of chronic total occlusion percutaneous coronary intervention: a report from the NCDR (National Cardiovascular Data Registry). JACC: Cardiovascular Interventions 2015;8:245-53. DOI: https://doi.org/10.1016/j.jcin.2014.08.014
Thygesen K, Alpert JS, White HD. Universal definition of myocardial infarction. J Am Coll Cardiol 2007;50:2173-95. DOI: https://doi.org/10.1016/j.jacc.2007.09.011
Ayad SW, El Zawawy TH, Lotfy MI, et al. Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome. Egyptian Heart J 2021;73:1-9. DOI: https://doi.org/10.1186/s43044-021-00160-x
Galassi AR, Tomasello SD, Reifart N, et al. In-hospital outcomes of percutaneous coronary intervention in patients with chronic total occlusion: insights from the ERCTO (European Registry of Chronic Total Occlusion) registry. EuroIntervention 2011;7:472-79. DOI: https://doi.org/10.4244/EIJV7I4A77
Vemmou E, Alaswad K, Patel M, et al. Chronic total occlusion percutaneous coronary intervention in octogenarians and nonagenarians. J Am Ger Soc 2021;69:1560-9. DOI: https://doi.org/10.1111/jgs.17063
Grantham JA, Marso SP, Spertus J, et al. Chronic total occlusion angioplasty in the United States. JACC: Cardiovascular Interventions 2009;2:479-86. DOI: https://doi.org/10.1016/j.jcin.2009.02.008
Abbott JD, Kip KE, Vlachos HA, et al. Recent trends in the percutaneous treatment of chronic total coronary occlusions. Am J Cardiol 2006;97:1691-96. DOI: https://doi.org/10.1016/j.amjcard.2005.12.067
Patel VG, Brayton KM, Tamayo A, et al. Angiographic success and procedural complications in patients undergoing percutaneous coronary chronic total occlusion interventions: a weighted meta-analysis of 18,061 patients from 65 studies. JACC: Cardiovascular Interventions 2013;6:128-36. DOI: https://doi.org/10.1016/j.jcin.2012.10.011
Thompson CA, Jayne JE, Robb JF, et al. Retrograde techniques and the impact of operator volume on percutaneous intervention for coronary chronic total occlusions: an early US experience. JACC: Cardiovascular Interventions 2009;2:834-42. DOI: https://doi.org/10.1016/j.jcin.2009.05.022
Morino Y, Kimura T, Hayashi Y, et al. In-hospital outcomes of contemporary percutaneous coronary intervention in patients with chronic total occlusion: insights from the J-CTO Registry (Multicenter CTO Registry in Japan). JACC: Cardiovascular Interventions 2010;3:143-51.
Michael TT, Karmpaliotis D, Brilakis ES, et al. Procedural outcomes of revascularization of chronic total occlusion of native coronary arteries (from a multicenter United States registry). American J Cardiol 2013;112:488-92. DOI: https://doi.org/10.1016/j.amjcard.2013.04.008
Mehran R, Claessen BE, Godino C, et al. Long-term outcome of percutaneous coronary intervention for chronic total occlusions. JACC: Cardiovascular Interventions 2011;4:952-61. DOI: https://doi.org/10.1016/j.jcin.2011.03.021
Steinmetz C, Bjarnason-Wehrens B, Baumgarten H, et al. Prehabilitation in patients awaiting elective coronary artery bypass graft surgery–effects on functional capacity and quality of life: a randomized controlled trial. Clinical rehabilitation 2020;34:1256-67. DOI: https://doi.org/10.1177/0269215520933950
Weintraub WS, Garratt KN. Chronic Total Occlusion Should Not Routinely be Treated with Coronary Artery Bypass Grafting. Circulation 2016;133:1818. DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.017798
Furkalo SN. Chronic total occlusion in patients after coronary artery bypass grafting: a review of possible interventions and results with a case study. EMJ 2016;1:133-39. DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.017797
Goldman S, Zadina K, Moritz T, et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol 2004;44:2149-56. DOI: https://doi.org/10.1016/j.jacc.2004.08.064

How to Cite

Abdulah, D. M., & Miro, S. S. . (2022). Prevalence and correlated factors for chronic total occlusion in patients with coronary artery disease in Iraqi Kurdistan. Annals of Clinical and Biomedical Research, 3(1). https://doi.org/10.4081/acbr.2022.170