Abstract 17349: Outcomes of Percutaneous Coronary Intervention (PCI) of Acute Myocardial Infarction (AMI) Patients With Chronic Total Occlusion (CTO) - National Database

Abstract

Introduction: Presence of Chronic Total Occlusion (CTO) in patients with Acute Myocardial Infarction (AMI) undergoing Percutaneous Coronary Intervention (PCI) has not been studied previously. Hypothesis: To study in-hospital mortality & resource utilization of AMI patients undergoing PCI associated with presence of CTO. Methods: We queried National Inpatient Sample from October 2015 - December 2017 using ICD 10 codes to identify patients over 18 years of age who underwent PCI & had AMI with presence or absence of CTO. SAS 9.4 was used for univariate and multivariate analysis. Propensity score matching was performed to matched CTO vs Non-CTO group’s baseline characteristics & Elixhauser comorbidities with Absolute standardized difference of 10% as matching limit. Results: A total of 576760 patients were identified who underwent PCI with AMI, out of which 525535 (91.12%) had no CTO while 51225(8.8%) had CTO. Each matched group contains 51210 patients. The In-hospital mortality was significantly higher in AMI PCI patients with CTO compared to Non-CTO (4.7% vs 3%, p <0.0001). Length of hospital stay was higher in CTO patients (median 2 vs 3, p =0.001) and less percentage of patients were discharged to home (78.8% vs 81.1%, p <0.0001). Median cost of hospital stay was higher in CTO group (20921$ vs 19856$, p <.0001). Conclusions: Analysis of this large database of patients undergoing PCI with AMI suggests that presence of CTO results in higher In-hospital mortality, with longer hospital stay & higher cost. Future observational studies should be directed towards CTO based outcomes in AMI patients undergoing PCI.