The acute and long-term outcome of patients with ST segment elevation myocardial infarction concurrent with chronic total occlusion.
10.3760/cma.j.cn112148-20201012-00805
- Author:
Tian Jie WANG
1
;
Jun Le DONG
1
;
Yan WANG
1
;
Yan Yan ZHAO
1
;
Ge CHEN
1
;
Hai Yan QIAN
1
;
Jian Song YUAN
1
;
Lei SONG
1
;
Shu Bin QIAO
1
;
Jin Gang YANG
1
;
Wei Xian YANG
1
;
Yue Jin YANG
1
Author Information
1. Coronary Heart Disease Center, National Center for Cardiovascular Diseases and Fuwai Hospital, China Academy of Medical Science and Peking Union Medical College, Beijing 100037, China.
- Publication Type:Journal Article
- MeSH:
Aged;
China;
Chronic Disease;
Coronary Occlusion/complications*;
Humans;
Male;
Middle Aged;
Myocardial Infarction;
Percutaneous Coronary Intervention;
Risk Factors;
ST Elevation Myocardial Infarction/surgery*;
Treatment Outcome
- From:
Chinese Journal of Cardiology
2021;49(6):586-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the acute and long-term outcome of patients with ST segment elevation myocardial infarction (STEMI) concurrent with chronic total occlusion (CTO) undergoing primary percutaneous coronary intervention (PCI). Methods: 11 905 STEMI patients from the China Acute Myocardial Infarction Registry were enrolled in this study and divided into CTO group and non-CTO group according to the angiography results of primary PCI. 1∶3 propensity score matching was used to match the patients between the two groups. The primary endpoint was in-hospital mortality and mortality at 1-year post PCI. The secondary endpoint was major adverse cardiovascular events (MACE) including death, re-myocardial infarction, revascularization, heart failure associated readmission, stroke and major bleeding at 1-year post PCI. Results: There were 931 CTO patients (7.8%) in this cohort (male=755 (81.1%), mean age (62.2±11.4 years)). The rest 10 974 patients were STEMI without CTO (male=8 829 (80.5%),mean age (60.0±11.8) years). After propensity score matching, 896 patients were enrolled in CTO group and 2 688 in non-CTO group. In-hospital mortality was significantly higher in the CTO group than in non-CTO group (4.2% vs. 2.4%, P=0.006). The ratio of all cause death, cardiac death, and MACE at 1-year follow up was also significantly higher in the CTO group than in non-CTO group (8.5% vs. 4.4%, P<0.001, 5.3% vs. 2.6%, P=0.001, 35.1% vs. 23.3%, P<0.001, respectively). Multiple regression analysis showed that CTO (HR=1.54, 95%CI 1.06-2.22, P=0.022), advanced age (HR=1.06, 95%CI 1.04-1.08, P<0.001), and previous heart failure history (HR=4.10, 95%CI 1.90-8.83, P<0.001) were independent risk factors of 1-year mortality. Conclusions: The in-hospital and 1-year mortality increased significantly in STEMI patients concurrent with CTO. CTO, advanced age and history of heart failure are independent risk factors of 1-year death among STEMI patients.
