title: Impact of multivessel coronary disease with chronic total occlusion on one-year mortality in patients with acute myocardial infarction.
abstract: OBJECTIVE
  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.
  
  
  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 ≥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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Ju Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Hun Sik
authors.initials: HS
authors.lastname: Park
authors.forename: Hyeon Min
authors.initials: HM
authors.lastname: Ryu
authors.forename: Hyunsang
authors.initials: H
authors.lastname: Lee
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Bae
authors.forename: Jang Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong Heon
authors.initials: DH
authors.lastname: Yang
authors.forename: Yongkeun
authors.initials: Y
authors.lastname: Cho
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Jae-Eun
authors.initials: JE
authors.lastname: Jun