Chronic total occlusion (CTO) represents the most technically challenging lesion subset for interventional cardiologists and remains undertreated with percutaneous techniques. Hypertension, a strong modifiable risk factor in coronary artery disease (CAD), is known to contribute to severity of CAD through several mechanisms such as shearing forces, reduced endothelial functions and vascular remodeling that aggravate coronary stenosis. The aim of this study was to analyze the effect of hypertension on complexity of CTO lesions.
It was an observational analytic study conducted on 122 patients who had CTO based on angiographic data in Hasan Sadikin Hospital within January 2015-December2016. Subjects were divided into hypertensive and non-hypertensive groups and compared with respect to components of Japan Chronic Total Occlusion (J-CTO) Score. Associations of hypertension and components of J-CTO Score were analyzed with Chi-Square test and difference of J-CTO Score between groups was analyzed with Mann-Whitney U test.
Hypertension was found in 74 (60.7%) subjects. There were no significant different in term of age, BMI, gender, DM, smoking, dyslipidemia and family history between groups. Hypertension was found to be significantly associated with blunted entry shape (OR 2.625, CI 1.232–5.591, p = 0.011) and bending vessels more than 45° (OR 3.4, CI 1.4–8.299, p = 0.005). We found a significant difference in J-CTO Score between 2 groups (p = 0.000).
Hypertension is found as a risk factor in majority of CTO subjects. Hypertensive patients are tends to have blunted entry shape, more than 45° bending vessels and have significantly different J-CTO Score compared to non-hypertensive patients.