Prevalence and management of coronary chronic total occlusions in a tertiary veterans affairs hospital

Omar M. Jeroudi, Mohammed E. Alomar, Tesfaldet T. Michael, Abdallah El Sabbagh, Vishal G. Patel, Owen Mogabgab, Eric Fuh, Daniel Sherbet, Nathan Lo, Michele Roesle, Bavana V. Rangan, Shuaib M. Abdullah, Jeffrey L. Hastings, Jerrold Grodin, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

81 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)637-643
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume84
Issue number4
DOIs
StatePublished - Oct 1 2014

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Veterans Hospitals
Tertiary Care Centers
Coronary Artery Bypass
Coronary Artery Disease
Transplants
Percutaneous Coronary Intervention
Veterans
Coronary Vessels
Population
Morbidity
Coronary Occlusion
Coronary Angiography
Angiography
Pathologic Constriction
Referral and Consultation

Keywords

  • coronary artery disease
  • coronary occlusion
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Prevalence and management of coronary chronic total occlusions in a tertiary veterans affairs hospital. / Jeroudi, Omar M.; Alomar, Mohammed E.; Michael, Tesfaldet T.; Sabbagh, Abdallah El; Patel, Vishal G.; Mogabgab, Owen; Fuh, Eric; Sherbet, Daniel; Lo, Nathan; Roesle, Michele; Rangan, Bavana V.; Abdullah, Shuaib M.; Hastings, Jeffrey L.; Grodin, Jerrold; Banerjee, Subhash; Brilakis, Emmanouil S.

In: Catheterization and Cardiovascular Interventions, Vol. 84, No. 4, 01.10.2014, p. 637-643.

Research output: Contribution to journalArticle

Jeroudi, Omar M. ; Alomar, Mohammed E. ; Michael, Tesfaldet T. ; Sabbagh, Abdallah El ; Patel, Vishal G. ; Mogabgab, Owen ; Fuh, Eric ; Sherbet, Daniel ; Lo, Nathan ; Roesle, Michele ; Rangan, Bavana V. ; Abdullah, Shuaib M. ; Hastings, Jeffrey L. ; Grodin, Jerrold ; Banerjee, Subhash ; Brilakis, Emmanouil S. / Prevalence and management of coronary chronic total occlusions in a tertiary veterans affairs hospital. In: Catheterization and Cardiovascular Interventions. 2014 ; Vol. 84, No. 4. pp. 637-643.
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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.",
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T1 - Prevalence and management of coronary chronic total occlusions in a tertiary veterans affairs hospital

AU - Jeroudi, Omar M.

AU - Alomar, Mohammed E.

AU - Michael, Tesfaldet T.

AU - Sabbagh, Abdallah El

AU - Patel, Vishal G.

AU - Mogabgab, Owen

AU - Fuh, Eric

AU - Sherbet, Daniel

AU - Lo, Nathan

AU - Roesle, Michele

AU - Rangan, Bavana V.

AU - Abdullah, Shuaib M.

AU - Hastings, Jeffrey L.

AU - Grodin, Jerrold

AU - Banerjee, Subhash

AU - Brilakis, Emmanouil S.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - 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.

AB - 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.

KW - coronary artery disease

KW - coronary occlusion

KW - percutaneous coronary intervention

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