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Impact of complete revascularization on long-term clinical outcomes for patients with diabetes mellitus and coronary chronic total occlusion lesion

Authors
Rha, Seung-WoonLi, HuChoi, Cheol UngChoi, Byoung Geol
Issue Date
Oct-2022
Publisher
Springer Verlag
Keywords
Coronary artery disease; Chronic total occlusion; Percutaneous coronary intervention; Medication therapy; Diabetes mellitus
Citation
Heart and Vessels, v.37, no.10, pp.1679 - 1688
Indexed
SCIE
SCOPUS
Journal Title
Heart and Vessels
Volume
37
Number
10
Start Page
1679
End Page
1688
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/60898
DOI
10.1007/s00380-022-02079-y
ISSN
0910-8327
Abstract
Diabetes mellitus (DM) is a substantial risk factor in developing coronary artery disease (CAD), coronary chronic total occlusion (CTO) lesions are discovering 10-35% in patients who underwent coronary angiography. This study compares the long-term clinical outcomes of two treatment strategies, percutaneous coronary intervention (PCI) with complete recanalization versus medication therapy (MT) with CTO lesion in DM patients with CTO. This study is a single-center, prospective, all-comer registry designed to reflect "real world" practice since 2004. Of a total of 4909 consecutive patients were diagnosed with significant CAD by coronary angiography (CAG). A total of 372 patients has DM and CTO lesions. Patients were divided into the PCI group (n = 184) and the MT group (n = 179). The primary endpoint, defined as the composite of death or myocardial infarction (MI), was compared between the two groups up to 5 years. In addition, inverse probability weighting (IPTW) analysis, derived from the logistic regression model, was performed to adjust for potential confounders. Compared to the MT group, the PCI group was associated with a significantly reduced incidence of the primary endpoint before [hazard ratio; HR 0.267, 95% confidence interval (CI) 0.116-0.614] and after (HR 0.142, 95% CI 0.032-0.629) adjusting confounding factors by IPTW. Complete revascularization by CTO-PCI with MT in DM patients should be the preferred treatment strategy compared with the MT alone strategy since it reduces the composite of death or MI up to 5 years.
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4. Research institute > Cardiovascular Research Institute > 1. Journal Articles
2. Clinical Science > Department of Cardiology > 1. Journal Articles

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