PMID- 20930044
OWN - NLM
STAT- MEDLINE
DCOM- 20110127
LR  - 20101122
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 96
IP  - 24
DP  - 2010 Dec
TI  - Prevalence and impact of a chronic total occlusion in a non-infarct-related 
      artery on long-term mortality in diabetic patients with ST elevation myocardial 
      infarction.
PG  - 1968-72
LID - 10.1136/hrt.2010.197673 [doi]
AB  - BACKGROUND: Recently, a chronic total occlusion (CTO) in a non-infarct-related 
      artery (non-IRA) and not multivessel disease (MVD) alone was identified as an 
      independent predictor of mortality after ST elevation myocardial infarction 
      (STEMI). Patients with diabetes mellitus (DM) constitute a patient group with a 
      high prevalence of MVD and high mortality after STEMI. The prevalence of CTO in a 
      non-IRA was studied and its impact on long-term mortality in STEMI patients with 
      DM was investigated. METHODS: Between 1997 and 2007 4506 patients with STEMI were 
      admitted and treated with primary percutaneous coronary intervention (PCI). 
      Patients with DM were identified. The patients were categorised as having single 
      vessel disease (SVD), MVD without CTO and CTO based on the angiogram before PCI. 
      RESULTS: A total of 539 patients (12%) had DM. MVD with or without a CTO was 
      present in 33% of non-diabetic patients and in 51% of diabetic patients. The 
      prevalence of a CTO in a non-IRA was 21% in STEMI patients with DM and 12% in 
      STEMI patients without DM (p<0.01). Kaplan-Meier estimates for 5-year mortality 
      in STEMI patients with DM were 25%, 21% and 47% in patients with SVD, MVD without 
      a CTO and MVD with a CTO in a non-IRA, respectively. A CTO in a non-IRA was an 
      independent predictor of 5-year mortality (HR 2.2, 95% CI 1.3 to 3.5, p<0.01). 
      CONCLUSION: The prevalence of a CTO in a non-IRA was increased in STEMI patients 
      with DM. The presence of a CTO in a non-IRA was a strong and independent 
      predictor of 5-year mortality. These results suggest that, particularly in the 
      high-risk subgroup of STEMI patients with DM, MVD has prognostic implications 
      only if a concurrent CTO is present.
FAU - Claessen, Bimmer E P M
AU  - Claessen BE
AD  - Department of Cardiology, Academic Medical Centre, University of Amsterdam, 
      Amsterdam, The Netherlands.
FAU - Hoebers, Loes P
AU  - Hoebers LP
FAU - van der Schaaf, Rene J
AU  - van der Schaaf RJ
FAU - Kikkert, Wouter J
AU  - Kikkert WJ
FAU - Engstrom, Annemarie E
AU  - Engstrom AE
FAU - Vis, Marije M
AU  - Vis MM
FAU - Baan, Jan Jr
AU  - Baan J Jr
FAU - Koch, Karel T
AU  - Koch KT
FAU - Meuwissen, Martijn
AU  - Meuwissen M
FAU - van Royen, Niels
AU  - van Royen N
FAU - de Winter, Robbert J
AU  - de Winter RJ
FAU - Tijssen, Jan G P
AU  - Tijssen JG
FAU - Piek, Jan J
AU  - Piek JJ
FAU - Henriques, Jose P S
AU  - Henriques JP
LA  - eng
PT  - Journal Article
DEP - 20101007
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2010 Dec;96(24):1955-6. PMID: 21036804
MH  - Aged
MH  - Cause of Death
MH  - Chronic Disease
MH  - Coronary Artery Disease/*mortality
MH  - Coronary Occlusion/epidemiology/*mortality
MH  - Diabetic Angiopathies/*mortality
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*mortality
MH  - Netherlands/epidemiology
MH  - Prevalence
EDAT- 2010/10/12 06:00
MHDA- 2011/01/29 06:00
CRDT- 2010/10/09 06:00
PHST- 2010/10/09 06:00 [entrez]
PHST- 2010/10/12 06:00 [pubmed]
PHST- 2011/01/29 06:00 [medline]
AID - hrt.2010.197673 [pii]
AID - 10.1136/hrt.2010.197673 [doi]
PST - ppublish
SO  - Heart. 2010 Dec;96(24):1968-72. doi: 10.1136/hrt.2010.197673. Epub 2010 Oct 7.