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Chronic total occlusion intervention of the non-infarct-related artery in acute myocardial infarction patients: the Korean multicenter chronic total occlusion registry

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Author(s)
Seung-Ho HurYangsoo JangJi Young ParkaByoung Geol ChoibSeung-Woon RhacTae Soo KanghCheol Ung ChoicCheol Woong YudHyeon-Cheol GwoneIn-Ho ChaeiHyo-Soo KimHun Sik ParkSeung-Hwan LeeMoo-Hyun Kim
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Coron Artery Dis
Issued Date
2018
Volume
29
Issue
6
Keyword
acute myocardial infarctionchronic total occlusionpercutaneous coronary intervention
Abstract
Background
The Korean chronic total occlusion (CTO) registry was collected prospectively from 26 cardiovascular centers since May 2007. The aim of this study is to investigate the impact of a successful staged percutaneous coronary intervention (PCI) of CTO lesions in acute myocardial infarction (AMI) patients on clinical outcomes.

Patients and methods
Among 2813 patients who underwent a staged PCI because of CTO lesions, 422 (15%) patients underwent primary PCI because of AMI. Among 422 patients, successful staged CTO-PCI was performed in 76%. The clinical outcomes were compared between the successful CTO-PCI group (n=321) and the failed CTO-PCI group (n=101). To adjust for potential confounders, a propensity score matching (PSM) analysis was carried out using the logistic regression model.

Results
After the PSM analysis, two propensity-matched groups (85 pairs, n=170) were generated and the baseline characteristics were balanced. The incidence of total death (P=0.029) and non-ST-segment elevation myocardial infarction (NSTEMI, P=0.043) at 1 year was higher in the failed CTO-PCI group. Multivariate regression showed that successful CTO-PCI was an independent predictor of preventing mortality (hazard ratio, 0.21, P=0.048). In the subgroup analysis, the Kaplan–Meier curve showed that successful CTO-PCI had a lower incidence of total death (log-rank=0.004) and cardiac death (log-rank=0.005) up to 1 year in NSTEMI patients. Cox-proportional analysis showed that successful CTO-PCI was beneficial in patients with NSTEMI, hypertension, and non-left-anterior descending artery lesion for preventing mortality.

Conclusion
In this study, a staged successful CTO-PCI in AMI patients was associated with improved 1-year survival in the Korean population.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Citation
Seung-Ho Hur et al. (2018). Chronic total occlusion intervention of the non-infarct-related artery in acute myocardial infarction patients: the Korean multicenter chronic total occlusion registry. Coron Artery Dis, 29(6), 495–501. doi: 10.1097/MCA.0000000000000630
Type
Article
ISSN
1473-5830
Source
https://insights.ovid.com/pubmed?pmid=29688904
DOI
10.1097/MCA.0000000000000630
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41708
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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