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

• Published in: Korean circulation journal Vol. 42; no. 2; pp. 95 - 99
• Main Authors: Lee, Ju Hwan, Park, Hun Sik, Ryu, Hyeon Min, Lee, Hyunsang, Bae, Myung Hwan, Lee, Jang Hoon, Yang, Dong Heon, Cho, Yongkeun, Chae, Shung Chull, Jun, Jae-Eun
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Cardiology 01.02.2012; 대한심장학회
• Subjects: Original; 내과학; Myocardial infarction; Prognosis; Chronic disease; Coronary occlusion
• ISSN: 1738-5520; 1738-5555; 1738-5555
• DOI: 10.4070/kcj.2012.42.2.95

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. We studied 1008 consecutive patients who underwent coronary angiography between November 2005 and December 2008 with a diagnosis of AMI. 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 ≥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). 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.