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Clinical results of percutaneous coronary intervention in chronic total occlusions of the right coronary artery

2024-03Journal article Open access
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dc.contributor.authorCosta, Hugo
dc.contributor.authorEspirito-Santo, Miguel
dc.contributor.authorBispo, João
dc.contributor.authorGuedes, João
dc.contributor.authorMimoso, Jorge
dc.contributor.authorPalmeiro, Hugo
dc.contributor.authorGonçalves, Rui Baptista
dc.contributor.authorVinhas, Hugo
dc.date.accessioned2024-11-22T13:04:41Z
dc.date.available2024-11-22T13:04:41Z
dc.date.issued2024-03
dc.description.abstractIntroduction and Objectives: Coronary chronic total occlusions (CTOs) of the right coronary artery (RCA) are a relatively common finding in the context of coronary angiography. However, the benefit of revascularization remains controversial. Methods: A single -center retrospective cohort analysis prospectively collected outcomes of CTO patients undergoing percutaneous coronary intervention (PCI) in 2019 and 2020. Patients were divided into two groups according to the CTO vessel treated (left coronary artery [LCA]-CTO or RCA-CTO). The primary outcome was defined as the recurrence of angina and/or heart failure (HF) symptoms and secondary outcomes were myocardial infarction (MI) and all -cause mortality. Results: A total of 177 patients (82.5% male) were included in the analysis, with a mean age of 65 +/- 11 years. The primary outcome occurred in 28 (16.6%) patients and was significantly more frequent in RCA-CTO patients (19, 24.7%, p=0.010) in a mean follow-up of 18 months. This was mainly driven by recurrence of HF symptoms (12, 15.6%, p=0.013). Treated RCA-CTO was an independent predictor of the primary outcome (p=0.019, HR 2.66, 95% CI 1.17-6.05). MI and mortality rates were no different between groups (RCA-CTO with 1.3%, p=0.361 and 2.6%, p=0.673, respectively, on survival analysis). Left ventricular ejection fraction was an independent predictor of mortality (p=0.041, HR 0.93, 95% CI 0.87-0.99). Conclusions: Revascularization of CTO lesions by PCI was associated with low rates of symptom recurrence, and clinical outcomes showed no differences regardless of which artery was treated. Recanalization of RCA-CTO was less beneficial in reducing the recurrence of HF symptoms. eng
dc.identifier.doi10.1016/j.repc.2023.07.011
dc.identifier.issn0870-2551
dc.identifier.urihttp://hdl.handle.net/10400.1/26324
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation.ispartofRevista Portuguesa de Cardiologia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectChronic total occlusions
dc.subjectRight coronary artery
dc.subjectSymptom recurrence
dc.subjectClinical outcomes
dc.titleClinical results of percutaneous coronary intervention in chronic total occlusions of the right coronary arteryeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage138
oaire.citation.issue3
oaire.citation.startPage131
oaire.citation.titleRevista Portuguesa de Cardiologia
oaire.citation.volume43
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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