Background

Myocardial infarction (MI) is known to be associated with increased adverse clinical outcomes in coronary artery diseases. The impact of percutaneous coronary intervention (PCI) for CTO in patients with myocardial infarction is not clear. We evaluated the 12-month clinical outcomes between PCI and optimal medical therapy (OMT) for CTO lesions in MI patients.

Methods

A total of 143 consecutive CTO patients who were admitted for MI were divided into 2 groups according to treatment strategy; PCI group (n=68) and OMT group (n=75). 12-month clinical outcomes were compared between the two groups.

Results

At baseline, patients in the OMT group showed a higher prevalence of elderly, hyperlipidemia, peripheral vascular disease, de novo lesion, non-CTO procedure, multivessel disease, and LCX-CTO. Patients in the PCI group showed a higher prevalence of prior MI, prior PTCA, and LAD-CTO lesion. Clinical outcomes at 12 months showed lower mortality and lower rates of recurrent MI in the PCI group. After baseline adjustment by multivariate analysis, however, there was no difference.

Conclusion

In our study, intervention shows a possibility of being a favorable choice of therapy for CTO lesions in MI patients in terms of 12-month mortality and MI-related morbidity. Long-term follow up with a larger study population will be necessary for further determination of the benefit and risks of interventional therapy in CTO patients.

Copyright © 2014 Published by Elsevier Inc.