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Outcomes of diabetic patients submitted to chronic total occlusion PCI
Session:
Posters (Sessão 2 - Écran 3) - Doença arterial coronária
Speaker:
Hugo Costa
Congress:
CPC 2023
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
12. Coronary Artery Disease (Chronic)
Subtheme:
12.8 Coronary Artery Disease - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Hugo Alex Costa; Miguel Espirito Santo; Raquel Fernandes; Daniela Carvalho; João Bispo; João Guedes; Hugo Vinhas; Jorge Mimoso; Ilidio Jesus
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Introduction: </strong>Coronary chronic total occlusions (CTO) are relatively common findings in the context of coronary angiography. The indication for revascularization of this type of lesions remains controversial. There is little knowledge about clinical outcomes between type 2 diabetic (DM2) and nondiabetic patients submitted to CTO by percutaneous coronary intervention (PCI). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Objectives: </strong>Our aim<strong> </strong>was to analyze the clinical benefit and outcomes of diabetic patients submitted to CTO PCI. Additionally, we specifically aimed to identify independent predictors to symptoms recurrence in this population.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Methods:</strong> <span style="color:black">A retrospective analysis was carried out of CTO patients submitted to PCI between 2019-2020. Patients were divided in two groups regarding previous DM2 (with-DM2 and without-NDM2). Composite primary outcome (</span>recurrence of angina and/or heart failure (HF) symptoms<span style="color:black">) and secondary outcomes (</span>myocardial infarction and death<span style="color:black">) were compared between both groups. Independent predictors of primary outcome were assessed by multivariate logistic regression</span>. P value < 0.05 indicates statistical significance.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Results:</strong> A total of 177 patients were identified, with a mean age of 65±11 years, 82.5% male. 75% showed hypertension, 40% with diabetes, 73% with dyslipidemia, 18% with obesity and HF in 15%, without differences between groups. DM2 patients were older with a mean age of 67,9±10,1 (p=0.010), with more chronic renal failure (14.3%, p=0.011), worst creatinine clearance 69.3±27.9 (p=0.006) and less use of contrast during PCI (225±84.8, p=0.009). Both groups improved LVEF after intervention (p<0.001). Symptoms recurrence occurred in 18% of patients after 2 years. Composite primary outcome was not significant higher in DM2 group (15.5% vs 22.7%, p=0.238). Angina recurrence was significant higher in DM2 group (5.80% vs 15.2%, p=0.043). Secondary outcomes were low after 2 years, without difference between groups. Right coronary artery (RCA) CTO vessel treated was an independent predictor for total symptoms recurrence after PCI (p=0.014, OR 2.86, 95% CI 1.24 to 6.60), although presence of diabetes was not (p=0.324, OR 1.53, 95% CI 0.66 to 3.53).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Calibri",sans-serif"><strong>Conclusion: </strong>DM2 patients submitted to CTO PCI were not associated with higher two-years total symptoms recurrence, mortality or myocardial infarction when compared with NDM2. Isolated angina recurrence was more frequent in DM2 patients. RCA CTO was an independent predictor for total symptoms recurrence.</span></span></p>
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