Impact of Percutaneous Coronary Intervention for Chronic Total Occlusion in Non–Infarct-Related Arteries in Patients With Acute Myocardial Infarction (from the COREA-AMI Registry)

Chronic total occlusion (CTO) in a non–infarct-related artery (IRA) is an independent predictor of clinical outcomes in patients with acute myocardial infarction (AMI). This study evaluated the impact of successful percutaneous coronary intervention (PCI) for CTO of a non-IRA on the long-term clinic...

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Published in:The American journal of cardiology 2016-04, Vol.117 (7), p.1039-1046
Main Authors: Choi, Ik Jun, MD, Koh, Yoon-Seok, MD, PhD, Lim, Sungmin, MD, Choo, Eun Ho, MD, Kim, Jin Jin, MD, Hwang, Byung-Hee, MD, Kim, Tae-Hoon, MD, PhD, Seo, Suk Min, MD, Kim, Chan Joon, MD, Park, Mahn-Won, MD, PhD, Shin, Dong Il, MD, PhD, Choi, Yun-Seok, MD, PhD, Park, Hun-Jun, MD, PhD, Her, Sung-Ho, MD, PhD, Kim, Dong-Bin, MD, PhD, Park, Chul Soo, MD, PhD, Lee, Jong-Min, MD, PhD, Moon, Keon Woong, MD, PhD, Chang, Kiyuk, MD, PhD, Kim, Hee Yeol, MD, PhD, Yoo, Ki-Dong, MD, PhD, Jeon, Doo Soo, MD, PhD, Chung, Wook-Sung, MD, PhD, Ahn, Youngkeun, MD, PhD, Jeong, Myung Ho, MD, PhD, Seung, Ki-Bae, MD, PhD, Kim, Pum-Joon, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Cardiology
Cardiovascular
Chronic Disease
Clinical outcomes
Coronary Occlusion - complications
Coronary Occlusion - mortality
Coronary Occlusion - therapy
Electrocardiography
Female
Follow-Up Studies
Heart attacks
Humans
Male
Middle Aged
Mortality
Myocardial Infarction - complications
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Percutaneous Coronary Intervention
Proportional Hazards Models
Registries
Time Factors
Treatment Outcome
Veins & arteries
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Summary:Chronic total occlusion (CTO) in a non–infarct-related artery (IRA) is an independent predictor of clinical outcomes in patients with acute myocardial infarction (AMI). This study evaluated the impact of successful percutaneous coronary intervention (PCI) for CTO of a non-IRA on the long-term clinical outcomes in patients with AMI. A total of 4,748 patients with AMI were consecutively enrolled in the Convergent Registry of Catholic and Chonnam University for AMI registry from January 2004 to December 2009. We enrolled 324 patients with CTO in a non-IRA. To adjust for baseline differences, propensity matching (96 matched pairs) was used to compare successful PCI and occluded CTO for the treatment of CTO in non-IRA. The primary clinical end points were all-cause mortality and a composite of the major adverse cardiac events, including cardiac death, MI, stroke, and any revascularization during the 5-year follow-up. Patients who received successful PCI for CTO of non-IRA had lower rates of all-cause mortality (16.7% vs 32.3%, hazard ratio 0.459, 95% CI 0.251 to 0.841, p = 0.012) and major adverse cardiac events (21.9% vs 55.2%, hazard ratio 0.311, 95% CI 0.187 to 0.516, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.12.049