Impact of total occlusion of the infarct-related coronary artery on mortality of 2483 patients with acute myocardial infarction

Table 1 Demographic characteristics, comorbidities, atherosclerotic disease, and chronic therapy, n (%)

Variable	Occluded artery (n = 1687, 67.9%)	Patent artery (n = 796, 32.1%)	P value
Age (years)	63 (55-73)	66.3 (58-75)	< 0.0001
Male sex	1206 (72.9)	572 (71.87)	0.584
Comorbidities
Atrial fibrillation	95 (5.7)	65 (8.2)	0.018
Arterial hypertension	1176 (71.1)	624 (78.4)	< 0.0001
Diabetes mellitus	346 (20.9)	236 (29.6)	< 0.0001
Family history of CV diseases	545 (33.0)	280 (35.2)	0.649
Smoking	676 (40.6)	278 (34.9)	< 0.001
BMI (kg/m2)	27.8 (25.3-30.9)	27.8 (25.0-30.5)	0.388
Extent of atherosclerotic disease
Carotid stenosis	60 (3.6)	54 (6.8)	< 0.0001
Peripheral artery disease	89 (5.4)	66 (8.3)	< 0.005
Previous CABG	26 (1.6)	14 (1.8)	0.735
Previous PCI	140 (8.5)	89 (11.2)	0.030
Previous MI	166 (10.0)	117 (14.7)	< 0.0001
Previous stroke	83 (5.0)	46 (5.8)	0.427
Chronic therapy (> 4 weeks before AMI)
ASA	269 (16.3)	178 (22.4)	< 0.0001
ACEi/ARB	618 (37.4)	335 (22.1)	0.005
Beta-blockers	372 (22.5)	225 (28.3)	< 0.0001
Statins	255 (15.4)	174 (21.9)	< 0.0001

CV: Cardiovascular; BMI: Body mass index; CABG: Coronary artery bypass grafting; PCI: Percutaneous coronary intervention; AMI: Acute myocardial infarction; ASA: Acetylsalicylic acid; ACEi/ARB: Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker.

Table 2 Clinical presentation, laboratory values, Global Registry of Acute Coronary Events score, and percutaneous coronary intervention findings, n (%)

Variable	Occluded artery (n = 1687, 67.9%)	Patent artery (n = 796, 32.1%)	P value
STEMI	1350 (81.6)	184 (23.1)	< 0.0001
VT before/during PCI	48 (2.9)	17 (2.1)	0.278
Systolic BP on admission (mmHg)	130 (115-150)	140 (120-155)	< 0.0001
Cardiogenic shock	107 (6.5)	19 (2.49)	< 0.0001
Out-of-hospital arrest	62 (3.7)	12 (1.5)	0.003
GRACE score	141.5 (96-175)	144 (75-106)	0.300
Laboratory values
Hemoglobin (g/L)	143 (131-153)	141 (129-150)	0.003
eGFR (mL/minutes/1.73 m2)	73 (59-88)	73 (58-87)	0.539
LDL cholesterol (mmol/L)	3.5 (2.7-4.2)	3.1 (2.3-3.9)	< 0.0001
Creatine kinase - peak (U/L)	1629 (716-3406)	354 (163-812)	< 0.0001
Troponin I - peak (ng/L)	20315 (16289-22154)	55000 (1461-3525)	< 0.0001
PCI-related findings
SYNTAX score	21 (17-26)	23 (18-27)	< 0.0001
TIMI 3 as the final angiogram	1284 (77.6)	685 (86.1)	< 0.0001
Stenosis of the LMCA	60 (3.6)	80 (29.3)	< 0.0001

STEMI: ST-elevation myocardial infarction; VT: Ventricular tachycardia; PCI: Percutaneous coronary intervention; GRACE score: Global Registry of Acute Coronary Events score; eGFR: Estimated glomerular filtration rate; LDL: Low-density lipoprotein; SYNTAX: Synergy between percutaneous coronary intervention with taxus and cardiac surgery score; TIMI: Thrombolysis in myocardial infarction; LCMA: Left main coronary artery.

Table 3 Predictors of infarct-related artery occlusion (χ² = 93.053; df = 8; P < 0.0001)

Covariate	P value	Odd ratio	95%CI
Age	0.0023	0.9722	0.9547-0.9900
Sex (female)	0.2756	1.3301	0.7965-2.2212
Troponin I (max value)	< 0.0001	1.0000	1.0000-1.0001
Peripheral artery disease	0.8778	0.9400	0.4271-2.0688
Diabetes mellitus	0.1362	0.6968	0.4333-1.1206
Body mass index	0.3799	1.0212	0.9744-1.0703
eGFR	0.0794	0.9918	0.9827-1.0010
Statin therapy before AMI	0.0168	0.5768	0.3674-0.9057
Arterial hypertension	0.3112	0.7415	0.6784-1.2154

CI: Confidence interval; AMI: Acute myocardial infarction; eGFR: Estimated glomerular filtration rate.

Table 4 Cox proportional hazards regression for 30-day mortality (χ² = 97.130; df = 14; P < 0.0001)

Covariate	P value	Hazard ratio	95%CI
Age	< 0.0001	1.0626	1.0341-1.0919
Sex (female)	0.0974	1.5527	0.9229-2.6123
ECG presentation (NSTEMI)	0.8986	1.0404	0.5659-1.9128
Occluded culprit coronary artery	0.0031	3.0367	1.4543-6.3411
Ventricular tachycardia before or during PCI	0.0064	3.8458	1.4600-10.1299
Peripheral artery disease	0.1227	1.8168	0.8513-3.8774
Statin therapy before myocardial infarction	0.3300	1.3523	0.7368-2.4820
BMI	0.2116	1.0357	0.9802-1.0943
GRACE	0.0188	1.0065	1.0011-1.0120
LDL - cholesterol	0.2744	0.8894	0.7208-1.0974
SYNTAX	0.8050	1.0050	0.9659-1.0458
Diabetes mellitus	0.2122	1.2121	0.5257-1.3124
Arterial hypertension	0.9878	1.4245	0.7854-1.3154

CI: Confidence interval; ECG: Electrocardiographic; NSTEMI: Non-ST-elevation myocardial infarction; PCI: Percutaneous coronary intervention; SYNTAX: Synergy between percutaneous coronary intervention with taxus and cardiac surgery score; BMI: Body mass index; LDL: Low-density lipoprotein; GRACE: Global Registry of Acute Coronary Events.