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Benefits of successful percutaneous coronary intervention in chronic total occlusion patients with diabetes

Shuai Zhao1, Yan Chen2, Qingyi Wang3

  • 1Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, 169 West Changle Road, Xi'an, 710032, Shaanxi, People's Republic of China.

Cardiovascular Diabetology
|December 5, 2022
PubMed

Insights

Successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) significantly improves outcomes and quality of life (QOL) for diabetic patients. These benefits are comparable to non-diabetic patients, indicating CTO-PCI is an effective strategy for all.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diabetology

Background:

  • Diabetes is common in patients with chronic total occlusion (CTO).
  • Data on the impact of successful percutaneous coronary intervention (PCI) on clinical outcomes in diabetic CTO patients is controversial.
  • No studies have compared quality of life (QOL) after CTO-PCI in diabetic versus non-diabetic patients.

Purpose of the Study:

  • To evaluate the clinical outcomes and QOL after successful CTO-PCI in patients with and without diabetes.
  • To identify risk predictors for clinical outcomes in diabetic patients undergoing successful CTO-PCI.

Main Methods:

  • Prospective enrollment of consecutive patients undergoing elective CTO-PCI from April 2018 to May 2021.
  • Patients were divided into Diabetes and No Diabetes groups.
  • Collected data included baseline characteristics, symptoms, QOL, procedural details, complications, and 1-month and 1-year follow-up.

Main Results:

  • A total of 1076 patients underwent CTO-PCI; 34.76% had diabetes and presented with more comorbidities and complex lesions.
  • In-hospital and 1-year Major Adverse Cardiac Events (MACE) and all-cause mortality were similar between groups (p > 0.05).
  • Number of lesions per patient was an independent risk factor for MACE and mortality (p < 0.001).
  • Symptom severity and QOL significantly improved in both groups at 1 month and 1 year post-CTO-PCI, with similar improvements observed in diabetic patients.

Conclusions:

  • Successful CTO-PCI is an effective strategy for improving clinical outcomes, symptoms, and QOL in CTO patients with diabetes.
  • The positive impact of CTO-PCI on QOL is comparable between diabetic and non-diabetic patients.
  • CTO-PCI offers significant benefits for diabetic patients, addressing a critical unmet need in cardiovascular care.
Abstract

Keywords:
Chronic total occlusionClinical outcomesDiabetesQuality of lifeSymptoms

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