Abstracts :

Background
Coronary chronic total occlusions (CTOs) are among the most difficult forms of coronary artery disease, especially in people living with HIV (PLWH). In addition to traditional cardiovascular risk factors, HIV-related chronic inflammation, immune activation, endothelial dysfunction, and prothrombotic states contribute to early and complex coronary disease. Data on the feasibility and long-term success of percutaneous coronary intervention (PCI) for CTOs in PLWH are limited. This study assessed the procedural success, safety, and long-term outcomes of CTO-PCI in PLWH.
Methods
Between August 2015 and the present, 25 consecutive PLWH with angiographically confirmed coronary CTOs were prospectively enrolled and underwent PCI. All patients received comprehensive clinical assessments and coronary angiography, followed by standardized CTO-PCI techniques. Procedural details, in-hospital outcomes, and long-term clinical follow-up were analyzed.
Results
The average age was 48 years, with an average HIV duration of 4.1 years. CTO locations included the left anterior descending artery (n=15), right coronary artery (n=5), left main coronary artery with LAD involvement (n=1), and left circumflex artery (n=4). The average stent size was 3.0 × 30 mm, with fluoroscopy times ranging from 2 to 3 hours. Procedural success was achieved in 100% of cases without in-hospital complications. Over a follow-up period exceeding 5 years, three deaths occurred, none related to PCI. No major adverse cardiovascular events were observed. All patients reported significant and sustained symptom relief.
Conclusion
PLWH tend to develop complex coronary CTOs at a younger age, often early in the course of HIV infection. CTO-PCI in this group is feasible, safe, and linked to high procedural success and lasting clinical benefits. These findings underscore the growing role of advanced coronary interventions as a key part of future cardiovascular care strategies for PLWH.