Clinical characteristics of coronary chronic total occlusion in patients without myocardial ;infarction
10.3969/j.issn.1004-8812.2016.12.005
- VernacularTitle:无心肌梗死病史慢性完全闭塞病变冠心病患者的临床特征
- Author:
Jian ZHANG
;
Quanmin JING
;
Xiaozeng WANG
;
Yingyan MA
;
Geng WANG
;
Haiwei LIU
;
Bin WANG
;
Kai XU
;
Yaling HAN
- Keywords:
Myocardial infarction;
Chronic total occlusion;
Percutaneous coronary intervention
- From:
Chinese Journal of Interventional Cardiology
2016;24(12):683-687
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical, imaging and interventional data of patients with chronic total occlusion (CTO) lesions without myocardial infarction (MI) and to summarize the clinical and imaging characteristics of these patients. Methods The data of 2651 patients with CTO verified by coronary angiography between January 1995 and December 2014 were analyzed retrospectively. Results There were 1466 CTO patients (55. 3%) without MI (the control group) and 1185 CTO patients (44. 7%) with MI ( the MI group). The age, percentage of female patients, unstable angina, hypertention, mean triglyceride levels, left ventricular ejection fraction ( LVEF) were lower in the MI group than in the control group ( all P﹤0. 05). The rates of heart failure and serum creatinine levels were higher in the MI group than the control group (both P﹤0. 05). The rate of multi-vessel disease was higher in the control group than in the MI group (81. 4% vs. 76. 5%, P﹤0. 05). According to the target CTO vessel location, patients in the control group had lower rates of CTO in LAD (36. 2% vs. 40. 7%, P=0. 007) and higher rates of CTO in LCX (17. 0%vs. 12. 7%, P﹤0. 001). Patients in the control group without MI had better collateral circulation than that in the control group (32. 7% vs. 27. 0%, P﹤0. 001). There were no differences in success rate of PCI and complete revascularization between the two groups. Conclusions The present study showed that the CTO patients without MI were associated with better collateral development compared with the CTO patients with MI. Age, gender, unstable angina encouraging ischemic preconditioning and hypertension may be beneficial by facilitating collateral development through endogenous cardioprotective mechanisms.
