Related Experiment Video
Updated: May 21, 2025
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
Prevalence and Clinical Parameters Associated With Chronic Total Occlusions in Patients With Chronic Coronary
Armin Attar1, Mehrab Sayadi2, Alireza Hosseinpour1,3
1Department of Cardiovascular Medicine Shiraz University of Medical Sciences Shiraz Iran.
Insights
Approximately 1 in 5 patients with chronic coronary syndrome (CCS) without prior bypass surgery had coronary chronic total occlusions (CTO). Older age, male gender, smoking, diabetes, and dyslipidemia increase CTO risk.
Area of Science:
- Cardiology
- Vascular Medicine
- Public Health
Background:
- Limited data exists on the prevalence and associated factors of coronary chronic total occlusions (CTO) in patients with chronic coronary syndrome (CCS).
- Understanding these factors is crucial for risk stratification and management strategies in cardiovascular disease.
Purpose of the Study:
- To determine the prevalence and anatomical location of coronary CTOs in a national cohort of CCS patients.
- To identify clinical and demographic factors associated with the presence of CTOs in this population.
Main Methods:
- Analysis of a national database registry (Persian CardioVascular Disease Registry) including 40,161 CCS patients without prior coronary artery bypass graft surgery (CABG).
- Coronary angiography data was used to identify CTO lesions.
- Logistic regression analysis was employed to determine factors associated with CTO presence.
Main Results:
- 17.86% of CCS patients (6805 out of 40,161) had at least one CTO.
- CTO patients were significantly older and more likely to be male.
- The left anterior descending and right coronary arteries were the most common sites for CTOs.
- Independent predictors for CTO included older age, male gender, smoking, diabetes mellitus, and dyslipidemia.
Conclusions:
- Coronary CTOs are prevalent in approximately 1 in 5 CCS patients without prior CABG.
- Advanced age, male gender, smoking, diabetes, and dyslipidemia are significantly associated with a higher likelihood of developing coronary CTOs.
Background And Aims:
The prevalence of coronary chronic total occlusions (CTO) among patients with chronic coronary syndrome (CCS) and their associations with clinical factors have received limited study. We analyzed a national database registry to determine the prevalence, location, and parameters associated with coronary CTOs.
Methods:
We identified all CCS patients without prior coronary artery bypass graft surgery (CABG) who underwent coronary angiography in the Persian CardioVascular Disease Registry (PCVDR). We compared the baseline demographics and characteristics of patients with vs. without at least one CTO lesion. We used logistic regression analysis to identify parameters associated with coronary CTOs.
Results:
Among the 40,161 patients with CCS who underwent coronary angiography between March 2019 and December 2023, 6805 (17.86%) had at least one CTO. CTO patients were significantly older (64.43 ± 8.96 years vs. 62.64 ± 9.54 years, p < 0.001) and more likely to be men (75.3% vs. 54.4%, p < 0.001). The left anterior descending artery (70.4%) and right coronary artery (16.5%) were the most common CTO lesion locations. Older age (adjusted odds ratio [aOR] 95% confidence intervals [CI] 1.024 (1.021-1.028), male gender (aOR 2.865 (2.685-3.058), any smoking (aOR 1.256 (1.145-1.378), diabetes mellitus (aOR 1.372 (1.288-1.460), and dyslipidemia (aOR 1.166 (1.096-1.239) were independently associated with the presence of a CTO.
Conclusion:
Approximately 1 in 5 CCS patients without prior CABG undergoing coronary angiography in this national database registry had a CTO. Advanced age, male gender, history of smoking, diabetes mellitus, and dyslipidemia were associated with higher likelihood of coronary CTOs.
Related Concept Videos
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...