Abstract
Introduction: The clinical profile of patients with coronary chronic total occlusions (CTO) has received limited study. We sought to examine the characteristics of patients presenting with CTOs in a contemporary veteran population. Methods: We collected clinical and angiographic data on 1,699 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. Patients with prior coronary artery bypass graft surgery (CABG) were excluded from analysis. Results: At least one CTO was identified in 319 of 1,015 patients (31%) with significant CAD. Compared to non-CTO patients, patients with a CTO were significantly more likely to have cardiac and non-cardiac comorbidities such as diabetes mellitus, peripheral arterial disease, congestive heart failure, prior myocardial infarction, and prior stroke. CTO patients presented more frequently with stable angina (37% vs. 30%, p =0.03) and had more extensive CAD ( p <0.001). Conclusions: In a contemporary veteran population, the presence of a coronary CTO was strongly associated with more extensive cardiac and non-cardiac comorbidities, CAD risk factors, and more extensive CAD.
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