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September 26, 2012Heart

Prevalence, predictors and clinical impact of unique and multiple chronic total occlusion in non-infarct-related artery in patients presenting with ST-elevation myocardial infarction

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Why the study?

Does the presence of chronic total occlusion (CTO) in a non-infarct-related artery impact 1-year mortality in STEMI patients undergoing primary PCI?

Population

2020 consecutive patients referred with STEMI between 2006 and 2011, categorized into single vessel disease…

Comparison

Primary percutaneous coronary intervention vs Comparison between single vessel disease, MVD…

Design

Cohort

Follow-up

1 year

Key result

In patients with STEMI, chronic total occlusion was not independently associated with 1-year mortality (HR 1.07; 95% CI 0.66-1.73; p=0.78) after adjusting for ejection fraction and renal function.

Authors

YBYoann BatailleJDJean‐Pierre DéryÉLÉric Larose

Discussion

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Member takes

Overview

CTO in STEMI was associated with worse survival; leaves open whether revascularization improves outcomes.

Study Design

Type

Observational (n=2,020)

Multicenter

No

Structured PICO

Does the presence of chronic total occlusion (CTO) in a non-infarct-related artery impact 1-year mortality in STEMI patients undergoing primary PCI?

P
Population
2,020 consecutive patients presenting with STEMI, evaluated for the presence and clinical impact of single or multiple chronic total occlusions on 1-year mortality.
E
Exposure
Primary percutaneous coronary intervention
C
Comparator
Comparison between single vessel disease, MVD without CTO, MVD with one CTO, and MVD with multiple CTOs
O
Outcome
1-year mortalityhard clinical

Main Result

Hazard Ratio: 1.07 (95% CI 0.66–1.73)

Absolute Event Rate: 28.1% vs 7.3%

p-value: p=0.78

Cite This Study

Bataille et al. (2012) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=2,020). Chronic total occlusion (CTO) vs. No CTO was evaluated on 1-year mortality (HR 1.07, 95% CI 0.66-1.73, p=0.78). In patients with STEMI, chronic total occlusion was not independently associated with 1-year mortality (HR 1.07; 95% CI 0.66-1.73; p=0.78) after adjusting for ejection fraction and renal function.

synapsesocial.com/papers/6a6a75479c58b04430f2b383https://doi.org/10.1136/heartjnl-2012-302376
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Also Consider

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

  1. 1Angiographic Assessment of Myocardial Reperfusion in Patients Treated With Primary Angioplasty for Acute Myocardial Infarction1998 · 1,306 citations
  2. 2Prevalence and impact of a chronic total occlusion in a non-infarct-related artery on long-term mortality in diabetic patients with ST elevation myocardial infarction2010 · 62 citations
  3. 3Percutaneous Recanalization of Chronically Occluded Coronary Arteries2005 · 564 citations
  4. 4Non-culprit coronary artery percutaneous coronary intervention during acute ST-segment elevation myocardial infarction: insights from the APEX-AMI trial2010 · 228 citations
  5. 5Percutaneous coronary intervention for acute coronary syndrome due to graft failure2012 · 9 citations