Incidence and clinical impact of concurrent chronic total occlusion according to gender in ST‐Elevation myocardial infarction. Issue 1 (26th February 2013)

• Record Type: Journal Article
• Authors: Bataille, Yoann; Déry, Jean‐Pierre; Larose, Éric; Abdelaal, Eltigani; Machaalany, Jimmy; Rodés‐Cabau, Josep; Rinfret, Stéphane; Déry, Ugo; Costerousse, Olivier; Roy, Louis; Bertrand, Olivier F.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 82:Issue 1(2013:Jul. 01)
• Page Start: 19
• Page End: 26
• Publication Date: 2013-02-26
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24697
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd24697-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine the prevalence of a concurrent CTO in men and women and to examine its impact on mortality.</p> </sec> <sec id="ccd24697-sec-0002" sec-type="section"> <title>Background</title> <p>The impact of chronic total occlusion (CTO) in patients with ST‐elevation myocardial infarction (STEMI) according to gender has not been assessed.</p> </sec> <sec id="ccd24697-sec-0003" sec-type="section"> <title>Methods</title> <p>Patients referred with STEMI were categorized into single vessel disease (SVD), multivessel disease (MVD) without, with 1 or > 1 CTO. The primary end‐point was the 1‐year mortality.</p> </sec> <sec id="ccd24697-sec-0004" sec-type="section"> <title>Results</title> <p>Among the 2020 STEMI patients included between 2006 and 2011, 24% were female. Women were older, had more hypertension and renal failure (<italic>P</italic> < 0.0001 for all). The prevalence of 1 or > 1 concurrent CTO was similar in both sexes, 7 and 1%, respectively. Early and late mortality was significantly higher in women compared with men (<italic>P</italic> < 0.0001). In women, the mortality was significantly worse in patients with > 1 CTO (100%) and with 1 CTO (36.4%) compared with those with MVD without CTO (18.4%) or with SVD (10.4%) (<italic>P</italic> < 0.0001). MVD with and without concurrent CTO were both independent predictors of 1‐year mortality in women (HR 3.58; 95 % CI 1.69–7.18 and HR 2.76; 95 % CI 1.33–5.51) whereas only MVD with CTO was predictive in men (HR 2.19; 95% CI 1.20–3.97).</p> </sec> <sec id="ccd24697-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Among unselected STEMI patients, the prevalence of CTO was equal in both sexes whereas early and late mortality remained significantly higher in women. Other factors than the presence of a concurrent CTO must be explored to explain differences in survival after STEMI between women and men. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>