Influence of percutaneous coronary intervention for revascularization on clinical prognosis in patients with chronic total occlusion lesions complicated by diabetes:A retrospective analysis
Tian Jinfan
Zuo Huijuan
Yang Xueyao
An Ziyu
Liu Libo
Zhang Lijun
He Yi
Song Xiantao
Abstract：Objective The prognosis of percutaneous coronary intervention for the patients with chronic total occlusive(CTO-PCI)lesions remains inconsistent,especially for CTO patients complicated by diabetes mellitus(CTO+DM),and the prognosis after CTO-PCI has been under investigation.The study was to retrospectively analyze CTO patients complicated by diabetes,and compare the influence of CTO-PCI and medication on prognosis.Methods The patients with CTO+DM(n=170)were respectively chosen from Department of Cardiology in Beijing Anzhen Hospital affiliated to Capital Medical University from Feb.2015 to Mar.2022,among them there were 122 patients with successful CTO-PCI(CTO-PCI group)and 48 patients treated with drugs(mediation group).The median duration of follow-up was 28.50 months.The primary endpoints were major adverse cardiovascular events(MACE),including cardiac death,non-fatal myocardial infarction,unplanned revascularisation,in-stent restenosis,heart failure and stroke.The changes of left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)were compared between 2 groups before and after treatment.Results The total incidence of MACE was 22.9%(39/170).The incidence of MACE was 23.8%(29/122)in CTO-PCI group and 20.8%(10/48)in medication group.The results of Kaplan-Meier survival curve analysis showed that CTO-PCI did not reduce MACE occurrence(Log-rank=0.375,P=0.540).The results of multi-factor Cox regression analysis showed that CTO-PCI did not reduce MACE occurrence(HR=1.452,95%CI:0.649～3.250,P=0.364).The comparison before and after CTO-PCI showed that LVEF[(60.460±7.623)%vs.(60.160±8.119)%],LVEDD[(47.800±5.606)mm vs.(49.236±5.491)mm]and LVESD[(32.850±6.144)mm vs.(33.389±7.059)mm]had no statistical differences.The comparison before and after medication showed that LVEF[(60.690±6.226)%vs.(63.750±6.506)%],LVEDD[(49.250±3.890)mm vs.(48.813±2.762)mm]and LVESD[(33.130±3.907)mm vs.(32.000±4.226)mm]had no statistical differences.Conclusion In this single-center study,no further reduction in MACE and improvement in heart function are observed in CTO-PCI group compared with medication group.
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Publication Date：2024-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 188-192 )