Abstract
IntroductionChronic total occlusion (CTO) in non-infarct related artery (nIRA) is associated with poor outcomes in patients with Acute Myocardial Infarction (AMI). The aim of the meta-analysis is to compare the outcomes of successfully staged percutaneous intervention (PCI) of nIRA CTO versus non revascularized CTO (failed PCI/no PCI/occluded) in patients admitted to hospital with AMI (ST segment elevation and non-ST segment elevation MI)MethodsPubMed, Embase and Cochrane databases were searched for studies comparing outcomes between staged PCI for CTO of nIRA and failed PCI/no PCI/occluded CTO patients admitted for AMI. The outcomes measured are all-cause mortality, cardiac mortality, Myocardial infarction (MI), revascularization, stroke, major adverse cardiac events (MACE) and heart failure readmission. Odds ratios (OR) and 95 % Confidence Intervals (CI) were calculated. The analysis was performed using DerSimonian and Laird random effect model.ResultsA total of 9 studies met the inclusion criteria with a total of 2091 patients (Successful PCI to CTO group1248 and Failed or no PCI/occluded CTO group843). After a mean follow up of 33.6 months the patients who had successful PCI to CTO had significantly lower MACE (OR 0.49, 95% CI 0.36-0.67), all-cause mortality (OR 0.46, 95% CI 0.26-0.80), Cardiac mortality (OR 0.34, 95% CI 0.23-0.49), MI, Stroke and heart failure readmission as compared to no PCI/occluded CTO group (Table.1). The rates of revascularization were similar in both the groupsConclusionsOur meta-analysis shows that successful staged PCI of nIRA CTO in patients admitted with AMI is associated with better outcomes compared to no revascularization