Conflict of interest: Nothing to report.
Coronary Artery Disease
Incidence and clinical impact of concurrent chronic total occlusion according to gender in ST-Elevation myocardial infarction
Article first published online: 26 FEB 2013
Copyright © 2013 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 82, Issue 1, pages 19–26, 1 July 2013
How to Cite
Bataille, Y., Déry, J.-P., Larose, É., Abdelaal, E., Machaalany, J., Rodés-Cabau, J., Rinfret, S., Déry, U., Costerousse, O., Roy, L. and Bertrand, O. F. (2013), Incidence and clinical impact of concurrent chronic total occlusion according to gender in ST-Elevation myocardial infarction. Cathet. Cardiovasc. Intervent., 82: 19–26. doi: 10.1002/ccd.24697
- Issue published online: 21 JUN 2013
- Article first published online: 26 FEB 2013
- Accepted manuscript online: 16 OCT 2012 10:48AM EST
- Manuscript Accepted: 5 OCT 2012
- Manuscript Received: 1 AUG 2012
- Centre Hospitalier Régional ‘Citadelle’, Liège, Belgium
- ‘Fonds Léon Fredericq’ at University of Liège, Belgium
- multivessel disease
To determine the prevalence of a concurrent CTO in men and women and to examine its impact on mortality.
The impact of chronic total occlusion (CTO) in patients with ST-elevation myocardial infarction (STEMI) according to gender has not been assessed.
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.
Among the 2020 STEMI patients included between 2006 and 2011, 24% were female. Women were older, had more hypertension and renal failure (P < 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 (P < 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%) (P < 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).
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.