Prognostic value of the presence of a chronic total occlusion in patients with acute myocardial infarction

Background: The presence of a chronic total occlusion (CTO) in a non-infarct-related artery in patients with acute myocardial infarction (AMI), may be a sign of bad prognosis. Aim: To estimate the long-term survival of patients with AMI who were studied with coronarography during 2013- 2014 who had one or more CTO in a non- infarct-related artery. Material and Methods: Review of coronary angiograms performed between 2013 and 2014 to patients with an AMI. Patients were grouped as having or not a CTO in a non- infarct-related artery. Their medical records were reviewed, and mortality was determined requesting their death certificates. Results: Of 993 patients with AMI undergoing coronarography, 233 (23.5%) had at least one CTO. Patients with CTO were older (66 and 62 years respectively). They also had a higher prevalence of hypertension, diabetes mellitus (DM), kidney failure and moderate to severe systolic ventricular dysfunction. The independent predictors of mortality were CTO, age, DM and kidney failure. Survival at an average follow-up period of 57 months was significantly higher in patients without CTO (89.5 and 80.3% respectively, p < 0.01). Conclusions The presence of CTO in patients with acute myocardial infarction is associated with a higher frequency of cardiovascular risk factors and lower long-term survival.