Clinical Characteristics and Outcome of Patients with Coronary Chronic Total Occlusion: Single Centre Study

Background: There is a significant gap in knowledge regarding clinical presentation, treatment decisions, and clinical follow-up for patients diagnosed with coronary chronic total occlusions (CTOs) in India.

Methods: All individuals >18 years diagnosed with CTO involving any vessel on coronary angiography at our institute were prospectively studied. Demographic details, treatment decisions, and 1-year follow-up were documented. The primary outcome variable was major adverse cardiovascular events at 1 year. Secondary outcome measures included symptom alleviation and the requirement of antianginal agents during follow-up. We also compared the outcomes of patients with and without revascularization.

Results: One hundred and fourteen consecutive patients (90.4% male, mean age of 59.5±9.8 years, and mean SYNTAX score of 28.3±11.1) with coronary CTO were studied. Angina (74.3%) was the predominant symptom. Seventy-six (66.7%) patients underwent successful coronary revascularization (PCI- 25.4%, CABG- 41.3%). At 1-year follow-up, there was no significant difference in mortality (p=0.07) and myocardial infarction (p=0.08) between the patients who underwent revascularization and who did not. Most patients (86.8%) showed symptomatic improvement, and 13.2% required additional antianginal agents for symptom alleviation.

Conclusion: Regardless of the status of revascularization, major adverse cardiovascular events and symptom alleviation did not differ significantly in patients with CTO.