Prognostic value of the presence of a chronic total occlusion in patients with acute myocardial infarction

• Published in: Revista medíca de Chile Vol. 150; no. 2; pp. 178 - 182
• Main Authors: Gajardo, Jorge, Pérez, Luis, Ibieta, Guillermo, Lecannelier, Eduardo, Venegas, Reinaldo, Garcés, Pamela, González, Alexis, Vera, Aldo, Robles, Isabel, Segall, Virginia
• Format: Journal Article
• Language: Spanish
• Published: 01-02-2022
• ISSN: 0717-6163
• DOI: 10.4067/S0034-98872022000200178

BACKGROUNDThe presence of a chronic total occlusion (CTO) in a non-infarct-related artery in patients with acute myocardial infarction (AMI), may be a sign of bad prognosis. AIMTo estimate the long-term survival of patients with AMI who were studied with coronarography during 2013-2014 who had one or more CTO in a non-infarct-related artery. MATERIAL AND METHODSReview of coronary angiograms performed between 2013 and 2014 to patients with an AMI. Patients were grouped as having or not a CTO in a non-infarct-related artery. Their medical records were reviewed, and mortality was determined requesting their death certificates. RESULTSOf 993 patients with AMI under-going coronarography, 233 (23.5%) had at least one CTO. Patients with CTO were older (66 and 62 years respectively). They also had a higher prevalence of hypertension, diabetes mellitus (DM), kidney failure and moderate to severe systolic ventricular dysfunction. The independent predictors of mortality were CTO, age, DM and kidney failure. Survival at an average follow-up period of 57 months was significantly higher in patients without CTO (89.5 and 80.3% respectively, p < 0.01). CONCLUSIONSThe presence of CTO in patients with acute myocardial infarction is associated with a higher frequency of cardiovascular risk factors and lower long-term survival.