Chronic total occlusions in Sweden--a report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

• Published in: PloS one Vol. 9; no. 8; p. e103850
• Main Authors: Råmunddal, Truls, Hoebers, Loes P, Hoebers, Loes, Henriques, Jose P S, Dworeck, Christian, Angerås, Oskar, Odenstedt, Jacob, Ioanes, Dan, Olivecrona, Göran, Harnek, Jan, Jensen, Ulf, Aasa, Mikael, Jussila, Risto, James, Stefan, Lagerqvist, Bo, Matejka, Göran, Albertsson, Per, Omerovic, Elmir
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 2014; Public Library of Science (PLoS)
• Subjects: Acute coronary syndromes; Aged; Angiography; Angioplasty; Arteries; Cardiac and Cardiovascular Systems; Cardiology; Cardiovascular disease; Clinical Medicine; Coronary Angiography; Coronary artery; Coronary Artery Bypass; Coronary artery disease; Coronary Occlusion - epidemiology; Coronary Occlusion - therapy; Coronary vessels; Diabetes mellitus; Ethics; Female; Heart; Heart diseases; Heart surgery; Humans; Intubation; Kardiologi; Klinisk medicin; Male; Medical and Health Sciences; Medical imaging; Medicin och hälsovetenskap; Medicine and Health Sciences; Methods; Middle Aged; Occlusion; Patients; Percutaneous Coronary Intervention; Prevalence; Registries; Reproducibility of Results; Review boards; Risk Factors; Risk groups; Stenosis; Stents; Studies; Subgroups; Surgery; Sweden - epidemiology; Systematic review; Task forces; Sweden; United States > US; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0103850

Evidence for the current guidelines for the treatment of patients with chronic total occlusions (CTO) in coronary arteries is limited. In this study we identified all CTO patients registered in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) and studied the prevalence, patient characteristics and treatment decisions for CTO in Sweden. Between January 2005 and January 2012, 276,931 procedures (coronary angiography or percutaneous coronary intervention) were performed in 215,836 patients registered in SCAAR. We identified all patients who had 100% luminal diameter stenosis known or assumed to be ≥ 3 months old. After exclusion of patients with previous coronary artery bypass graft (CABG) surgery or coronary occlusions due to acute coronary syndrome, we identified 16,818 CTO patients. A CTO was present in 10.9% of all coronary angiographies and in 16.0% of patients with coronary artery disease. The majority of CTO patients were treated conservatively and PCI of CTO accounted for only 5.8% of all PCI procedures. CTO patients with diabetes and multivessel disease were more likely to be referred to CABG. CTO is a common finding in Swedish patients undergoing coronary angiography but the number of CTO procedures in Sweden is low. Patients with CTO are a high-risk subgroup of patients with coronary artery disease. SCAAR has the largest register of CTO patients and therefore may be valuable for studies of clinical importance of CTO and optimal treatment for CTO patients.