Coronary disease & ACSCohort study
The Gulf Chronic Total Occlusion Registry
- Registry
- 7 tertiary centers in 4 Gulf countries
Authors' conclusion
After adjustment, no treatment strategy demonstrated superiority for hard cardiovascular outcomes; revascularization, particularly CABG, was associated with a lower angina burden at follow-up.
Study context
- Population
- Patients with angiographically confirmed chronic total occlusion (CTO), 2021–2023patients with angiographically confirmed CTO
- Participants
- 741 patients
- Exposure
- Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) vs medical therapy
- medical therapyn = 151
- PCIn = 441
- CABGn = 149
Main finding
As reported in the abstract
In-hospital major adverse cardiovascular events · in-hospital
- After adjustment, neither PCI nor CABG differed significantly from medical therapy
- adjusted
Observational data: associations, not effects.
Further findings
Canadian Cardiovascular Society class I · last follow-up — CABG vs medical therapy · significant · adjusted
P < 0.001
| Outcome | P value |
|---|---|
| Canadian Cardiovascular Society class I · last follow-up — PCI vs medical therapy · not significant · adjusted | P = 0.17 |
Major adverse cardiac and cerebrovascular events-free survival · median follow-up of 22 months; 36-month restricted mean survival time
- No statistically significant difference between PCI, CABG, and medical therapy
- adjusted
Baseline characteristics by treatment
- Medically managed patients had worse renal function, more severely reduced left ventricular ejection fraction, and more cardiogenic shock despite simpler CTO anatomy
- CABG patients had more extensive multivessel disease, whereas PCI patients had greater CTO lesion complexity
Original publication
The Gulf Chronic Total Occlusion Registry. JACC Adv. Published 6 August 2026. doi:10.1016/j.jacadv.2026.103015
Summarised from the published abstract; every number is checked against it