Korean Circ J.  2012 Feb;42(2):95-99. 10.4070/kcj.2012.42.2.95.

Impact of Multivessel Coronary Disease With Chronic Total Occlusion on One-Year Mortality in Patients With Acute Myocardial Infarction

• Lee JH
• Park HS
• Ryu HM
• Lee H
• Bae MH
• Lee JH
• Yang DH
• Cho Y
• Chae SC
• Jun JE

• KMID: 1826380
• DOI: http://doi.org/10.4070/kcj.2012.42.2.95

Abstract

BACKGROUND AND OBJECTIVES
The impact of multivessel coronary disease (MVD) with chronic total occlusion (CTO) on one-year mortality in patients with acute myocardial infarction (AMI) is not clearly known. We investigated the impact of MVD with concurrent CTO lesion on one-year mortality in patients with AMI.
SUBJECTS AND METHODS
We studied 1008 consecutive patients who underwent coronary angiography between November 2005 and December 2008 with a diagnosis of AMI.
RESULTS
Among 1008 patients, 432 patients (43%) had MVD, and 88 patients (8.7%) had CTO lesion. The one-year overall mortality was higher in patients with MVD than in patients with single vessel disease (SVD) (10.2% vs. 5.9%, p=0.012). However, the one-year overall mortality was not significantly higher in patients with CTO lesion than in patients without that lesion (12.5% vs. 7.3%, p=0.080). In multivariate analysis, independent predictors of one-year overall mortality were age older than 65 years {hazard ratio (HR) 2.41, 95% confidence interval (CI): 1.43 to 4.08}, Killip class > or =III (HR 3.59, 95% CI: 2.24 to 5.77), ST-elevation myocardial infarction (HR 2.45, 95% CI: 1.49 to 4.05) and MVD (HR 1.76, 95% CI: 1.07 to 2.89).
CONCLUSION
Patients with MVD showed higher one-year mortality than patients with SVD. However, the presence of CTO was not an independent predictor of one-year mortality in this study that included patients with successfully revascularized CTO lesion.

Keyword

Coronary occlusion; Myocardial infarction; Chronic disease; Prognosis

MeSH Terms

Chronic Disease
Coronary Angiography
Coronary Disease
Coronary Occlusion
Glycosaminoglycans
Humans
Multivariate Analysis
Myocardial Infarction
Prognosis
Glycosaminoglycans

Figure

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  Fig. 1 Twelve-month the overall mortality.

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  Fig. 2 Twelve-month mortality according to presence of chronic total occlusion.

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