title: Effect of multivessel coronary artery disease with or without a concomitant chronic total occlusion on 1-year survival in patients treated with rescue angioplasty.
abstract: BACKGROUND
  The effect of multivessel disease (MVD) with or without a concomitant chronic total occlusion (CTO) has never been investigated in patients treated with rescue percutaneous coronary intervention (PCI).
  
  
  OBJECTIVE
  This study evaluates whether there is an increased rate of death at 1-year follow-up in patients undergoing rescue PCI with angiographic pattern of MVD and a concurrent CTO in comparison with single-vessel disease (SVD) and MVD without CTO.
  
  
  METHODS
  Among 551 consecutive patients undergoing rescue PCI, we compared the 1-year survival rates of 361 patients with SVD, 137 with MVD without a CTO, and 53 with MVD and a CTO.
  
  
  RESULTS
  The 1-year mortality rates of patients with SVD, MVD without CTO, and MVD with CTO were 5%, 13%, and 27%, respectively (P<.001). The Cox proportional hazard model identified the presence of MVD with CTO as a strong predictor of death at 1-year follow-up (hazard ratio [HR], 3.4; 95% confidence interval [CI], 1.6-7.1; P=.001), while MVD alone did not result as a predictor of outcome (HR, 1.9; 95% CI, 0.9-3.8; P=.064). Adjusted 1-year overall survival rates were 96%, 91.4%, and 83.4% (P=.001) in the groups with SVD, MVD without CTO, and MVD with CTO, respectively.
  
  
  CONCLUSIONS
  Patients with MVD and concurrent CTO have higher mortality rates than those with SVD or MVD without CTO at 1-year follow-up after rescue PCI. MVD with CTO and not MVD alone is a predictor of death at 1-year follow-up.
authors: Cardiologia Interventistica Ospedale S. Camillo Roma, Cardiologia Interventistica Ospedale S. Camillo, C.ne Gianicolense n 87, Rome 00152, Italy. f.defelice@lycos.com
authors: Francesco
authors: F
authors: De Felice
authors: Francesca
authors: F
authors: Fiorilli
authors: Antonio
authors: A
authors: Parma
authors: Carmine
authors: C
authors: Musto
authors: Marco Stefano
authors: MS
authors: Nazzaro
authors: Pierpaolo
authors: P
authors: Confessore
authors: Massimiliano
authors: M
authors: Scappaticci
authors: Roberto
authors: R
authors: Violini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality* / Q000601:surgery; D054059:Coronary Occlusion / Q000150:complications / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome