Impact of Percutaneous Coronary Intervention for Chronic Total Occlusion in Non-Infarct-Related Arteries in Patients With Acute Myocardial Infarction (from the COREA-AMI Registry)

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• 作者：Ik Jun Choi ; MD^a ; Yoon-Seok Koh ; MD ; PhD^b ; Sungmin Lim ; MD^c ; Eun Ho Choo ; MD^d ; Jin Jin Kim ; MD^e ; Byung-Hee Hwang ; MD^e ; Tae-Hoon Kim ; MD ; PhD^b ; Suk Min Seo ; MD^a ; Chan Joon Kim ; MD^f ; Mahn-Won Park ; MD ; PhD^f ; Dong Il Shin ; MD ; PhD^a ; Yun-Seok Choi ; MD ; PhD^g ; Hun-Jun Park ; MD ; PhD^b ; Sung-Ho Her ; MD ; PhD^f ; Dong-Bin Kim ; MD ; PhD^e ; Chul Soo Park ; MD ; PhD^g ; Jong-Min Lee ; MD ; PhD^d ; Keon Woong Moon ; MD ; PhD^h ; Kiyuk Chang ; MD ; PhD^b ; Hee Yeol Kim ; MD ; PhD^c ; Ki-Dong Yoo ; MD ; PhD^h ; Doo Soo Jeon ; MD ; PhD^a ; Wook-Sung Chung ; MD ; PhD^b ; Youngkeun Ahn ; MD ; PhDⁱ ; Myung Ho Jeong ; MD ; PhDⁱ ; Ki-Bae Seung ; MD ; PhD^b ; Pum-Joon Kim ; MD ; PhD^b ; ^{bjheart@catholic.ac.kr" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：1 April 2016
• 年：2016
• 卷：117
• 期：7
• 页码：1039-1046
• 全文大小：892 K

文摘

Chronic total occlusion (CTO) in a non–infarct-related artery (IRA) is an independent predictor of clinical outcomes in patients with acute myocardial infarction (AMI). This study evaluated the impact of successful percutaneous coronary intervention (PCI) for CTO of a non-IRA on the long-term clinical outcomes in patients with AMI. A total of 4,748 patients with AMI were consecutively enrolled in the Convergent Registry of Catholic and Chonnam University for AMI registry from January 2004 to December 2009. We enrolled 324 patients with CTO in a non-IRA. To adjust for baseline differences, propensity matching (96 matched pairs) was used to compare successful PCI and occluded CTO for the treatment of CTO in non-IRA. The primary clinical end points were all-cause mortality and a composite of the major adverse cardiac events, including cardiac death, MI, stroke, and any revascularization during the 5-year follow-up. Patients who received successful PCI for CTO of non-IRA had lower rates of all-cause mortality (16.7% vs 32.3%, hazard ratio 0.459, 95% CI 0.251 to 0.841, p = 0.012) and major adverse cardiac events (21.9% vs 55.2%, hazard ratio 0.311, 95% CI 0.187 to 0.516, p <0.001) compared with occluded CTO group. Subgroup analyses revealed that successful PCI resulted in a better mortality rate in patients with normal renal function compared to patients with chronic kidney disease (p = 0.010). In conclusion, successful PCI for CTO of non-IRA is associated with improved long-term clinical outcomes in patients with AMI.