Brazilian registry of percutaneous coronary intervention in chronic total occlusions

Abstract

Background: Coronary chronic total occlusion is present in approximately one third of patients with coronary artery disease, and its management is challenging. Brazilian reports on percutaneous coronary intervention in this scenario are scarce. The objective of this study was to present contemporary data on percutaneous coronary intervention in chronic total occlusions. Methods: We analyzed the clinical, angiographic and procedural characteristics of all coronary interventions in chronic total occlusions of the Central Nacional de Intervenções Cardiovasculares (CENIC) performed between June 2006 and March 2016. In-hospital clinical events were also considered. For time trend analysis, the data were divided into periods/groups: 2006-2008 (Group 1), 2009-2011 (Group 2) and 2012-2016 (Group 3). Results: A total of 2,018 procedures were performed in 2,009 patients with chronic total occlusions. The mean age was 60.4±10.8 years, with an increase from the first to the third period (59.6±11.0 and 61.2±10.6 years, respectively; p<0.05), 21.9% of patients were diabetic, and 62.8% had single-vessel disease. There was an increase in the use of drug-eluting stents between the first and third periods (19.4% and 35.7%; p<0.0001). In the multivariate analysis, females (OR: 13.77; 95%CI 1.55-122.39; p=0.01) and use of glycoprotein IIb/IIIa inhibitors (OR: 32.29; 95%CI 6.03-172.75; p<0.0001) were associated with an increased risk of death. Conclusion: There was a temporal increase in the use of drug-eluting stents in the management of chronic total occlusions. Furthermore, female sex and the need for glycoprotein IIb/ IIIa inhibitors were associated with a higher risk of death.