Successful revascularization versus medical therapy in diabetic patients with stable right coronary artery chronic total occlusion: a retrospective cohort study

• DOI: 10.1186/s12933-019-0911-4
• Publication Date: 2019-08-21T10:02:48Z
• Authors: Yunfeng Yan; Mingduo Zhang; Fei Yuan; Hong Liu; Di Wu; Yudong Fan; Xinjing Guo; Feng Xu; Min Zhang; Quanming Zhao; Shuzheng Lyu
• Keywords: Male; Medical therapy; Time Factors; Risk Assessment; 03 medical and health sciences; Percutaneous Coronary Intervention; 0302 clinical medicine; Risk Factors; Diabetes Mellitus; Diseases of the circulatory (Cardiovascular) system; Humans; Angina, Stable; Coronary Artery Bypass; Original Investigation; Aged; Retrospective Studies; Revascularization; Diabetes; Cardiovascular Agents; Middle Aged; 3. Good health; Chronic total occlusion; Treatment Outcome; Coronary Occlusion; RC666-701; Chronic Disease; Female

The territory of the right coronary artery (RCA) is smaller than that left anterior descending artery. Previous studies have reported conflicting results when considering whether stable RCA-chronic total occlusion (CTO) should be reopened. coexistence diabetic and diseases represents a severe situation. Therefore, we aimed to determine if RCA-CTO in patients was necessary To our knowledge, no focused on this topic date. We enrolled with who had clinical presentations symptomatic angina or silent ischemia. treated either successful revascularization (the CTO-SR group) medical therapy CTO-MT group). primary endpoint all-cause death. Both Cox regression propensity score matching analyses were used. Sensitivity analysis performed based subgroup populations relevant baseline variables. A 943 included: 443 (46.98%) group 500 (53.02%) group. After mid-term follow-up (CTO-SR: 48 months; CTO-MT: 42 months), found superior terms death (adjusted hazard ratio [HR] [model 1]: 0.429, 95% conference interval [CI] 0.269–0.682; adjusted HR 2]: 0.445, CI 0.278–0.714). superiority consistent for cardiac death, possible/definite repeat revascularization, target vessel (TVR) nonfatal myocardial infarction. Subgroup confirmed mortality benefit by percutaneous intervention CTO-PCI subgroup, 309 total). While bypass grafting CTO-CABG 191 total) offered more from TVR CTO-PCI. For diabetes, benefits therapy. might recommended way accomplish revascularization. Trial registration This study not registered an open access database