Prognostic impact of CTO lesion in NSE-ACS patients: Three-year outcome

Abstract

CTO represents the most advanced form of CAD and affects adverse clinical outcomes in patients with AMI due to several pathophysiological mechanisms. The aim of this study was to determine the prognostic impact of chronic total occlusion (CTO) on two-year outcome in a prospective cohort of NSTE-ACS patients. CTO is present in many patients with NSTE-ACS and is difficult to treat with percutaneous coronary intervention. Patients admitted for NSTE-ACS and indication for coronary angiography were prospectively evaluated. Patients were divided into 2 groups according to whether CTO lesions were vs. were not present. Major outcomes were assessed at 3 years. A total of 296 patients were evaluated: mean age was 62 ± 12 years and 58% were male. The three-year mortality was 12.2% (36 patients) and the three-year MACCE was 26.4% (78 patients). The CTO group included 38 patients (12.2%). The three-year mortality and MACCE in the patients of CTO group was significantly higher (26.3% vs. 10.1%; P = 0.013) and (50.0% vs. 22.9%; P = 0.001) respectively. In this prospective observational study of patients with NSTE-ACS, CTO was associated with a worst three-year outcome.