Outcomes of Percutaneous Coronary Intervention in Chronic Total Occlusion among Women

Objective: To determine the outcomes in female patients who underwent percutaneous coronary intervention (PCI) for chronic total occlusion. Methodology: This longitudinal descriptive study was conducted at the Department of Cardiology, Fauji Foundation Hospital, Rawalpindi from July 2024 to March 2025 after taking approval from the ethical committee. A total of 56 female patients with a diagnosed chronic total occlusion (CTO) who had persistent angina symptoms despite optimal medical therapy were included using non-probability convenience sampling. All these patients were eligible to undergo CTO-PCI with normal kidney function and gave informed consent. The patients underwent CTO-PCI by interventional cardiologists. All the patients had a monthly follow-up for 3 months post-procedure. The outcomes assessed were rate of procedural success, in-hospital major adverse cardiovascular events (MACE) and cardiac mortality & symptom-free at 3 months. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 25. Results: The procedural success rate was found in 37(66.1%) patients. In-hospital MACE occurred in 5(8.9%) patients. Two (3.6%) patients died whereas, 40(71.4%) patients were symptom-free at 3 months. In-hospital MACE was significantly less in the successful CTO-PCI group (p-value=0.04) and the majority [34(94.4%)] of the patients in the successful CTO-PCI group were symptom-free at 3 months (p-value=0.001). However, there was no significant difference in mortality at 3 months between the two groups with a p-value of 0.53. The procedural failure was significantly associated with the elderly age group >60 years (p-value=0.02) and diabetes mellitus (p-value=0.004). Conclusion: The CTO-PCI has a procedural success rate of 66.1% and the majority of the patients were symptom-free after the procedure. The statistically significant outcomes were reduction in the frequency of in-hospital MACE and symptom-free at 3 months in the successful CTO-PCI group. The procedural failure was significantly associated with the elderly age group and diabetes mellitus.