BACKGROUND AND AIMS: Myocardial infarction (MI) in multivessel disease (MVD) and chronic total occlusion (CTO) is associated with high mortality. However, all-cause mortality of matched cohort without a CTO is unclear. Our aim was to analyse clinical characteristics, presenting symptoms, and survival of patients with MI in MVD and the possible impact of CTO on 1-year mortality. METHODS: All MI patients with MVD (two or three vessel disease) hospitalized in our center from January 2020 to September 2022 (1309 patients) were selected. We conducted a propensity score matching (PSM) analysis based on age, gender, type of MI, and compared patients with CTO (CTO group, n = 90) and without CTO (Control group, n = 90). RESULTS: We observed no difference in presenting clinical symptoms and initial heart rhythm between the groups. 1-year follow-up shows all-cause mortality rate of 23.3 % (n = 21) in the CTO group (Mean survival [MS] = 292.1 days, 95 % CI = 263.8 to 320.4) and 18.9 % (n = 17) in the Control group (MS = 310.2 days, 95 % CI = 285.3 to 335.2), p = 0.44. PCI alone was performed in 64.4 % (n = 58) in both groups, CABG in 18.8 % (n = 17) and 24.4 % (n = 22) (CTO vs. Control group respectively). Combination of PCI and CABG occurred in 8.8 % (n = 8) in both groups. Conservative treatment was chosen for 7 CTO and 2 Control group patients. CONCLUSION: We observed no 1-year mortality difference in patients with MI, MVD and a CTO compared to a matched cohort of patients with MI, MVD without CTO. Excellent 1-year survival was observed in patients treated by CABG, irrespective of CTO presence.

3rd Faculty of Medicine Charles University Prague Czech Republic

Department of Cardiology University Hospital Královské Vinohrady Prague Czech Republic

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