Arrhythmic Outcomes After Successful Chronic Total Coronary Occlusion Revascularization in Diabetic Versus Non-Diabetic Patients

Objective: This study aimed to compare the occurrence of arrhythmogenic events between non-diabetic and diabetic patients after successful chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Method: This prospective cohort observational study included 170 patients with at least one CTO lesion who underwent successful revascularization. The patients were divided into two groups: the diabetic group (n=70) and the non-diabetic group (n=100). All patients underwent full history taking, general physical examination, laboratory investigations, and angiographic and echocardiographic assessments.
Results: Compared with the non-diabetic group, the diabetic group exhibited a significantly higher incidence of arrhythmia following CTO PCI (45.71% vs. 24%, 95% CI: 1.2363–2.9346, P = 0.004), sustained ventricular arrhythmia (20% vs. 7%, 95% CI: 1.2159–6.7138, P = 0.016), and recurrent arrhythmia within 30 days (24.29% vs. 9%, 95% CI: 1.2772–5.7012, P = 0.008). In the parsimonious multivariable logistic regression model, multivessel disease remained independently associated with post-CTO PCI arrhythmia (adjusted OR 5.623, 95% CI: 2.709–11.671, P < 0.001), whereas diabetes mellitus (adjusted OR 1.528, 95% CI: 0.699–3.338, P = 0.288) and procedure duration (adjusted OR 1.025, 95% CI: 1.000–1.050, P = 0.054) were not independently associated with the outcome.
Conclusion: Diabetic patients experienced a significantly higher incidence of arrhythmogenic events following successful chronic total occlusion percutaneous coronary intervention (CTO PCI) compared with non-diabetic patients. However, after adjustment in a parsimonious multivariable model, multivessel disease, rather than diabetes mellitus itself, remained independently associated with post-CTO PCI arrhythmia.

Keywords: Arrhythmic outcomes, chronic total occlusion, diabetic, non-diabetic, revascularization.