DefinePK

Abstract

Introduction:  Chronic total occlusion (CTO) in acute coronary syndrome (ACS) is a very challenging clinical scenario with a higher risk of adverse outcomes. Hence, its management involves accurate assessments and sophisticated treatment methods. Objectives: To assess the prevalence, presentation, and prognosis of CTO in ACS to understand how percutaneous coronary intervention (PCI) affects patients. Materials and Methods: This study was a retrospective, consecutive, single-center observational analysis carried out in 150 patients with proven ACS who were diagnosed to have CTO at the NICVD Karachi, Pakistan in the duration from January 2024 to December 2024. Demographic data, the initial assessment of suitability for catheter ablation, procedural specifics, and further management were evaluated. A p-value of < 0.05 was used as the level of statistical significance. Results: The mean procedural success rate was 68% for PCI to reduce major adverse cardiac events as compared with more conservative treatment (15% vs 34%) and mortality (7% vs 20%). They noticed that collateral circulation was present in 82% of the patients, which brought down the mortality rates. Conclusion: PCI is associated with meaningful clinical improvement in CTO-ACS patients, but the procedure is technically demanding and requires proper preparation and experienced personnel. Therefore, these multisectoral approaches are crucial for the purpose of ensuring proper management.