Author + information
- Nirmanmoh Bhatia,
- Sahil Agrawal,
- Arash Nayeri,
- Divyanshu Mohananey,
- Pedro Villablanca,
- Manyoo Agarwal,
- Lohit Garg and
- Elias Haddad
Background: Chronic total occlusion (CTO) is implicated in worse outcomes from ST-Elevation Myocardial Infarction (STEMI) due to the “double jeopardy” concept. There is no large national data evaluating the trends and outcomes of STEMI patients who have a CTO (STEMI-CTO).
Methods: We analyzed the Nationwide In-Patient Sample database and compared trends, clinical characteristics and In-Hospital outcomes of STEMI pts with and without CTO.
Results: An increasing trend of concomitant CTO was seen in STEMI pts from 2008 to 2011 (9.7% to 13.1% of all STEMI admissions, relative increase 35%, p trend <0.001). STEMI-CTO patients were younger (61.8 vs 63.2 yrs, p<0.001), more likely to be male (74.3% vs. 67.4%, p<0.001), have family history of coronary artery disease (12.6% vs. 10.7%, p<0.001), had prior percutaneous coronary intervention (PCI) (12% vs. 10.4%, p<0.001), develop cardiogenic shock (CS) (11.4% vs. 10%, p<0.001), undergo PCI (87.6% vs. 76.1%, p <0.001) and thrombolysis (2.6% vs 2%, p<0.001). There was no difference in in-hospital death, pericardial complications or need for dialysis. However, STEMI-CTO pts were more likely to have iatrogenic cardiac complications, vascular complications, need percutaneous mechanical circulatory support (pMCS) and require both bypass surgery (CABG) and PCI (Table).
Conclusions: STEMI-CTO is increasing in incidence and these pts have a higher likelihood of having CS, require pMCS, have iatrogenic cardiac and vascular complications and undergo both CABG and PCI.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in Chronic Total Occlusion Intervention
Abstract Category: 20. Interventional Cardiology: Coronary Intervention: CTO
Presentation Number: 1282-125
- 2017 American College of Cardiology Foundation