66 92

Cited 11 times in

Current trends in patients with chronic total occlusions undergoing coronary CT angiography

Authors
 Maksymilian P Opolski  ;  Bríain ó Hartaigh  ;  Daniel S Berman  ;  Matthew J Budoff  ;  Stephan Achenbach  ;  Mouaz Al-Mallah  ;  Daniele Andreini  ;  Filippo Cademartiri  ;  Hyuk-Jae Chang  ;  Kavitha Chinnaiyan  ;  Benjamin J W Chow  ;  Martin Hadamitzky  ;  Joerg Hausleiter  ;  Gudrun Feuchtner  ;  Yong-Jin Kim  ;  Philipp A Kaufmann  ;  Jonathon Leipsic  ;  Erica Maffei  ;  Gianluca Pontone  ;  Gilbert Raff  ;  Leslee J Shaw  ;  Todd C Villines  ;  James K Min 
Citation
 HEART, Vol.101(15) : 1212-1218, 2015 
Journal Title
 HEART 
ISSN
 1355-6037 
Issue Date
2015
MeSH
Age Factors ; Aged ; Canada ; Cardiovascular Agents/therapeutic use* ; Chi-Square Distribution ; Chronic Disease ; Comorbidity ; Coronary Angiography/methods* ; Coronary Artery Bypass/trends* ; Coronary Occlusion/diagnostic imaging* ; Coronary Occlusion/epidemiology ; Coronary Occlusion/therapy* ; Coronary Stenosis/diagnostic imaging* ; Coronary Stenosis/epidemiology ; Coronary Stenosis/therapy* ; Europe ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multidetector Computed Tomography* ; Multivariate Analysis ; Odds Ratio ; Percutaneous Coronary Intervention/trends* ; Predictive Value of Tests ; Prevalence ; Prospective Studies ; Registries ; Republic of Korea ; Risk Factors ; Sex Factors ; Smoking/adverse effects ; Smoking/epidemiology ; Time Factors ; Treatment Outcome ; United States
Abstract
OBJECTIVE: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment strategies of CTO identified by CCTA. METHODS: We identified 23 745 patients who underwent CCTA for suspected coronary artery disease (CAD) from the prospective international CCTA registry. Baseline clinical data were collected, and allocation to early coronary revascularisation performed within 90 days of CCTA was determined. Multivariable hierarchical mixed-effects logistic regression reporting OR with 95% CI was performed. RESULTS: The prevalence of CTO was 1.4% (342/23 745) in all patients and 6.2% in patients with obstructive CAD (≥50% stenosis). The presence of CTO was independently associated with male sex (OR 3.12, 95% CI 2.39 to 4.08, p<0.001), smoking (OR 2.02, 95% CI 1.55 to 2.64, p<0.001), diabetes (OR 1.60, 95% CI 1.22 to 2.11, p=0.001), typical angina (OR 1.51, 95% CI 1.12 to 2.06, p=0.008), hypertension (OR 1.47, 95% CI 1.14 to 1.88, p=0.003), family history of CAD (OR 1.30, 95% CI 1.01 to 1.67, p=0.04) and age (OR 1.06, 95% CI 1.05 to 1.07, p<0.001). Most patients with CTO (61%) were treated medically, while 39% underwent coronary revascularisation. In patients with severe CAD (≥70% stenosis), CTO independently predicted revascularisation by coronary artery bypass grafting (OR 3.41, 95% CI 2.06 to 5.66, p<0.001), but not by percutaneous coronary intervention (p=0.83). CONCLUSIONS: CTOs are not uncommon in a contemporary CCTA population, and are associated with age, gender, angina status and CAD risk factors. Most individuals with CTO undergoing CCTA are managed medically with higher rates of surgical revascularisation in patients with versus without CTO. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier NCT01443637.
Files in This Item:
T201505768.pdf Download
DOI
10.1136/heartjnl-2014-306616
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157164
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse