title: Impact of the presence of chronically occluded coronary artery on long-term prognosis of patients with acute ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Multivessel disease (MVD) is a significant risk factor in patients with acute ST-segment elevation myocardial infarction (STEMI). Whether the presence of chronic total occlusion (CTO) poses an additional hazard is still unknown. The objective of this study was to evaluate the impact of CTO on survival in STEMI patients.
  
  
  METHODS
  The study group consisted of 836 STEMI patients treated with primary percutaneous coro-nary intervention (PCI). MVD was diagnosed in 52.3%, and CTO in 17.5% of patients.
  
  
  RESULTS
  In MVD patients, 30-day mortality was 4.8% (6.8% in the CTO and 3.8% in the non-CTO group, p = 0.167). After 6 years, of the 437 patients with MVD, 56 (38.6%) died in the CTO group, and 74 (25.4%) in the non-CTO group (p = 0.0055). CTO was an independent predictor of long-term mortality (OR 2.07, 95% CI 1.30-3.28, p = 0.002), whereas triple vessel disease was not (OR 1.27, 95% CI 0.78-1.97, p = 0.358). The other independent predictors of mortality were: age, anterior myocardial infarction, and PCI failure.
  
  
  CONCLUSIONS
  The presence of CTO is an independent predictor of the long-term mortality in STEMI patients treated with primary PCI. (Cardiol J 2017; 24, 2: 117-124).
authors.forename: Maciej
authors.initials: M
authors.lastname: Lesiak
authors.forename: Monika
authors.initials: M
authors.lastname: Cugowska
authors.affiliation: 1st Department of Cardiology, Poznan University of Medical Sciences. aaraszkiewicz@interia.pl.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Araszkiewicz
authors.forename: Marek
authors.initials: M
authors.lastname: Grygier
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Pyda
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Skorupski
authors.forename: Przemysław
authors.initials: P
authors.lastname: Mitkowski
authors.forename: Magdalena
authors.initials: M
authors.lastname: Łanocha
authors.forename: Stefan
authors.initials: S
authors.lastname: Grajek
mesh_terms: D002423:Cause of Death / Q000639:trends; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000150:complications* / Q000175:diagnosis; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: acute myocardial infarction; chronic total occlusion; multivessel disease