Copyright
©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2026; 18(1): 111736
Published online Jan 26, 2026. doi: 10.4330/wjc.v18.i1.111736
Published online Jan 26, 2026. doi: 10.4330/wjc.v18.i1.111736
Impact of total occlusion of the infarct-related coronary artery on mortality of 2483 patients with acute myocardial infarction
Nikola Kos, Vjekoslav Radeljic, Diana Delic-Brkljacic, Nikola Bulj, Department of Cardiology, University Hospital Centre Sestre Milosrdnice, Zagreb 10000, Croatia
Nikola Kos, Vjekoslav Radeljic, Diana Delic-Brkljacic, Nikola Bulj, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Ivan Zeljković, Department of Cardiology, University Hospital Dubrava, Zagreb 10000, Croatia
Ivan Zeljković, Faculty of Education, University of Zagreb, Zagreb 10000, Croatia
Karlo Golubic, Department of Cardiovascular Diseases, University Hospital Centre Sestre Milosrdnice, Zagreb 10000, Croatia
Karlo Golubic, School of Medicine, Catholic University of Croatia, Zagreb 10000, Croatia
Marijan Erceg, Department of Health, Croatian Institute of Public Health, Zagreb 10000, Croatia
Maja Cigrovski Berkovic, Faculty of Kinesiology, University of Zagreb, Zagreb 10000, Croatia
Co-corresponding authors: Nikola Kos and Maja Cigrovski Berkovic.
Author contributions: Kos N and Cigrovski Berkovic M contributed equally to this manuscript and are co-corresponding authors. Kos N conceptualized the study; Kos N, Zeljković I, Golubic K, Radeljic V, Erceg M, Delic-Brkljacic D, Cigrovski Berkovic M, and Bulj N collected the data and wrote the draft and final version of the manuscript; Golubic K performed the data analysis; all authors approved the final version.
Institutional review board statement: This study has been approved by the Ethics Committee of the Medical Faculty, University of Zagreb, No. 380-59-1 01 06-1 8-1 1 1 I 156.
Clinical trial registration statement: This study has been registered in a clinical trial registry, ClinicalTrials.gov ID: NCT07086807.
Informed consent statement: All patients gave written informed consent for participation in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Data can be shared by reasonable request by the corresponding authors.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikola Kos, MD, PhD, Department of Cardiology, University Hospital Centre Sestre Milosrdnice, Vinogradska 29, Zagreb 10000, Croatia. nikolakos89@gmail.com
Received: July 8, 2025
Revised: July 28, 2025
Accepted: December 3, 2025
Published online: January 26, 2026
Processing time: 191 Days and 11.7 Hours
Revised: July 28, 2025
Accepted: December 3, 2025
Published online: January 26, 2026
Processing time: 191 Days and 11.7 Hours
Core Tip
Core Tip: This large prospective study found that culprit coronary artery occlusion worsens the prognosis at 30 days, regardless of the electrocardiographic presentation. Patients with occluded arteries are younger and exhibited more severe clinical features, while those with patent arteries were older and had more chronic issues. The presence of occlusion increased the risk of short-term mortality threefold. Chronic statin use prior to the acute myocardial infarction was associated with a lower likelihood of artery occlusion. These findings suggest that angiographic assessment of culprit artery patency should be integrated into stratification of acute myocardial infarction beyond traditional ST-elevation/non-ST-segment patterns.