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October 16, 2012Catheterization and Cardiovascular Interventions

Incidence and clinical impact of concurrent chronic total occlusion according to gender in ST‐Elevation myocardial infarction

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Why the study?

Does the presence of concurrent chronic total occlusion impact 1-year mortality differently in men and women presenting with STEMI?

Population

2,020 patients referred with ST-elevation myocardial infarction between 2006 and 2011, 24% female. Women…

Comparison

Multivessel disease with 1 or >1 concurrent… vs Single vessel disease or multivessel disease…

Design

Cohort

Follow-up

1 year

Key result

Concurrent chronic total occlusion in STEMI patients independently predicted 1-year mortality in both women (HR 3.58; 95% CI 1.69-7.18) and men (HR 2.19; 95% CI 1.20-3.97).

Authors

YBYoann BatailleJDJean‐Pierre DéryÉLÉric Larose

Discussion

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Member takes

Overview

Concurrent CTO in STEMI was associated with higher 1-year mortality; leaves open gender-specific prognostic value and management implications.

Study Design

Type

Cohort (n=2,020)

Structured PICO

Does the presence of concurrent chronic total occlusion impact 1-year mortality differently in men and women presenting with STEMI?

P
Population
2,020 patients with STEMI, 24% female, followed for 1 year to assess the impact of concurrent chronic total occlusion on mortality.
E
Exposure
Multivessel disease (MVD) with 1 or >1 concurrent chronic total occlusion (CTO)
C
Comparator
Single vessel disease (SVD) or multivessel disease (MVD) without CTO
O
Outcome
1-year mortalityhard clinical

Main Result

Hazard Ratio: 3.58 (95% CI 1.69–7.18)

p-value: p=<0.0001

Concurrent CTO in STEMI patients is equally prevalent in men and women and serves as a strong independent predictor of 1-year mortality in both sexes, though women experience significantly higher overall mortality.

Cite This Study

Bataille et al. (2012) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=2,020). Concurrent chronic total occlusion (CTO) vs. No concurrent CTO (single vessel disease or multivessel disease without CTO) was evaluated on 1-year mortality (HR 3.58, 95% CI 1.69-7.18, p=<0.0001). Concurrent chronic total occlusion in STEMI patients independently predicted 1-year mortality in both women (HR 3.58; 95% CI 1.69-7.18) and men (HR 2.19; 95% CI 1.20-3.97).

synapsesocial.com/papers/6a6a75479c58b04430f2b382https://doi.org/10.1002/ccd.24697
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prevalence, predictors and clinical impact of unique and multiple chronic total occlusion in non-infarct-related artery in patients presenting with ST-elevation myocardial infarction2012 · 28 citations
  2. 2Impact of the presence of chronically occluded coronary artery on long-term prognosis of patients with acute ST-segment elevation myocardial infarction2016 · 6 citations
  3. 3Sex-Based Differences in Long-Term Outcomes Following Percutaneous Coronary Intervention for Chronic Total Occlusions2026
  4. 4The impact of Multivessel Disease with and Without a Co-Existing Chronic Total Occlusion on Short- and Long-Term Mortality in ST-Elevation Myocardial Infarction Patients with and without Cardiogenic Shock2012 · 104 citations
  5. 5Impact of Multivessel Coronary Disease With Chronic Total Occlusion on One-Year Mortality in Patients With Acute Myocardial Infarction2012 · 18 citations