Objectives: To determine the prevalence of a concurrent CTO in men and women and to examine its impact on mortality.
Background: The impact of chronic total occlusion (CTO) in patients with ST-elevation myocardial infarction (STEMI) according to gender has not been assessed.
Methods: Patients referred with STEMI were categorized into single vessel disease (SVD), multivessel disease (MVD) without, with 1 or > 1 CTO. The primary end-point was the 1-year mortality.
Results: Among the 2020 STEMI patients included between 2006 and 2011, 24% were female. Women were older, had more hypertension and renal failure (P < 0.0001 for all). The prevalence of 1 or > 1 concurrent CTO was similar in both sexes, 7 and 1%, respectively. Early and late mortality was significantly higher in women compared with men (P < 0.0001). In women, the mortality was significantly worse in patients with > 1 CTO (100%) and with 1 CTO (36.4%) compared with those with MVD without CTO (18.4%) or with SVD (10.4%) (P < 0.0001). MVD with and without concurrent CTO were both independent predictors of 1-year mortality in women (HR 3.58; 95 % CI 1.69-7.18 and HR 2.76; 95 % CI 1.33-5.51) whereas only MVD with CTO was predictive in men (HR 2.19; 95% CI 1.20-3.97).
Conclusions: Among unselected STEMI patients, the prevalence of CTO was equal in both sexes whereas early and late mortality remained significantly higher in women. Other factors than the presence of a concurrent CTO must be explored to explain differences in survival after STEMI between women and men.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/ccd.24697 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Conquering the obstacles during the intervention of a proximal chronic total occlusion of right coronary artery with a concurrent significant ostial stenosis: a case report.
J Pak Med Assoc
June 2024
Department of Cardiology & Vascular Medicine, Dr Soetomo General Hospital, Surabaya, Indonesia.
Percutaneous coronary intervention (PCI) on a proximal chronic total occlusion (CTO) of the right coronary artery (RCA) with concurrent ostial stenosis can be challenging because of the significant difficulty in properly engaging the catheter and providing stable support during the procedure. We report the case of a 57-year-old man with chronic coronary syndrome who underwent an elective PCI at the Dr. Soetomo General Hospital in Surabaya, on April 13th, 2022.
View Article and Find Full Text PDFPromising results following derotational femoral osteotomy in patellofemoral instability with increased femoral anteversion: A systematic review on current indications, outcomes and complication rate.
J Exp Orthop
July 2024
Swiss Olympic Medical Center, Hirslanden Clinique La Colline Geneva Switzerland.
Purpose: Patellofemoral joint instability (PFJI) can surgically be treated with a multitude of approaches, depending on the underlying pathology. In the presence of increased femoral anteversion, some authors have reported good results with a derotational distal femoral osteotomy (DeDFO). The purpose of the study was to investigate the indications, outcomes and complication rate of DeDFO for PFJI.
View Article and Find Full Text PDFTen-Year Outcome of Recanalization or Medical Therapy for Concomitant Chronic Total Occlusion After Myocardial Infarction.
J Am Heart Assoc
May 2024
Department of Cardiology, Heart Center, Amsterdam UMC, Location AMC Amsterdam Cardiovascular Sciences Amsterdam the Netherlands.
Article Synopsis
- - The EXPLORE trial was a 10-year study comparing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) to no-CTO PCI in patients who had a ST-segment-elevation myocardial infarction (STEMI).
- - The trial found that after a median follow-up of 10 years, there was no significant difference in major adverse cardiac events or overall mortality between the two groups, but the CTO PCI group experienced higher cardiovascular mortality.
- - Although the CTO PCI group had more effective relief from dyspnea (83% vs. 65%), the findings suggest that the benefits of symptom relief should be carefully considered against the increased risk of cardiovascular mortality.
Successful true cavity pathfinding with balloon assisted CTO with bifurcation lesions: Two case reports.
Medicine (Baltimore)
March 2024
Department of Cardiology, Cardiovascular and Cerebrovascular Disease Hospital of General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.
Background: Coronary artery disease is a prevalent global cardiovascular ailment, with percutaneous coronary intervention (PCI) standing out as a crucial method for relieving symptoms and enhancing the quality of life in patients with coronary heart disease. However, the presence of concurrent chronic total occlusion (CTO) and bifurcation lesions within coronary arteries elevates the complexity and treatment risks, especially when the entry point of the CTO is ambiguous.
Objective: This study aims to present an innovative approach for treating CTO complicated with bifurcation lesions, focusing on true cavity pathfinding assisted by a balloon.
Instrumented Pre-Hospital Care Simulation Mannequin for Use in Spinal Motion Restrictions Scenarios: Validation of Cervical and Lumbar Motion Assessment.
Sensors (Basel)
February 2024
Faculty of Engineering, Department of Electrical Engineering, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada.
Background: A mid-fidelity simulation mannequin, equipped with an instrumented cervical and lumbar spine, was developed to investigate best practices and train healthcare professionals in applying spinal motion restrictions (SMRs) during the early mobilization and transfer of accident victims with suspected spine injury. The study objectives are to (1) examine accuracy of the cervical and lumbar motions measured with the mannequin; and (2) confirm that the speed of motion has no bearing on this accuracy.
Methods: Accuracy was evaluated by concurrently comparing the orientation data obtained with the mannequin with that from an optoelectronic system.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!