Abstract 18335: Long-Term Follow-Up of Patients with Acute Myocardial Infarction with Chronic Total Occlusion in the Non-Infarct Related Artery
Introduction: It remains unclear whether revascularization of chronic total occlusion (CTO) of the non-infarct related artery (non-IRA) during the index episode of hospitalization will favorably alter long-term outcomes in patients with acute myocardial infarction (AMI).
Methods: We studied 208 consecutive patients with AMI and CTO in non-IRA who underwent urgent coronary angiography at National Cerebral and Cardiovascular Center in Japan between 2000 and 2010. The patients were divided into 3 groups according to the treatment during the index episode of AMI: 60 patients with successful PCI for CTO, 30 patients with CABG and 118 patients with optical medical therapy (OMT). Follow-up was obtained for total death and major adverse cardiac events (MACE), including cardiac death, recurrent myocardial infarction, repeat revascularization and re-hospitalization because of heart failure.
Results: During follow-up (median, 5.1 years), total death and MACE-free survival were lower in OMT group than PCI and CABG group (50.5%, 78.8% and 62.4%, p=0.03; 13.0%, 28.2% and 43.0%, p<0.0001, respectively). Cox proportional hazards model showed that coronary revascularization (PCI or CABG) was an independent predictor for 10-year MACE-free survival (HR=0.47, 95%CI 0.24-0.80, p<0.001), but not for total death.
Conclusions: Successful revascularization CTO in the non-IRA may improve clinical outcomes in patients with AMI.
- Myocardial infarction
- Acute coronary syndromes
- Coronary artery bypass grafting (CABG)
- Coronary artery disease
Author Disclosures: M. Fujino: None. M. Ishihara: None. S. Honda: None. S. Kawakami: None. T. Yamane: None. T. Nagai: None. K. Nakao: None. T. Kanaya: None. L. Kumasaka: None. Y. Asaumi: None. T. Arakawa: None. M. Nakanishi: None. T. Noguchi: None. K. Kusano: None. T. Anzai: None. Y. Goto: None. S. Yasuda: None. H. Ogawa: None.
- © 2014 by American Heart Association, Inc.