Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Impact of Multivessel Coronary Disease With Chronic Total Occlusion on One-Year Mortality in Patients With Acute Myocardial Infarction

  • Lee, Ju-Hwan (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Hun-Sik (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Ryu, Hyeon-Min (Department of Internal Medicine, Gumi CHA Hospital) ;
  • Lee, Hyun-Sang (Department of Internal Medicine, Gumi CHA Hospital) ;
  • Bae, Myung-Hwan (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Jang-Hoon (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Yang, Dong-Heon (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Cho, Yong-Keun (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Chae, Shung-Chull (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Jun, Jae-Eun (Department of Internal Medicine, Kyungpook National University School of Medicine)
  • Published : 2012.02.29
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Abstract

Background and Objectives: 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. Subjects and Methods: We studied 1008 consecutive patients who underwent coronary angiography between November 2005 and December 2008 with a diagnosis of AMI. Results: 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 ${\geq}$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). Conclusion: 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.

Keywords

References

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