Las arterias no culpables en el síndrome coronario agudo con elevación del segmento ST. Análise de 176 casos consecutivos

Introduction: Given the high prevalence of multivessel disease in the context of acute coronary syndrome with ST elevation, the main objective of this study was to analyze the mortality in the first 30 days of an acute coronary event according to the degree of the disease of non-infarct-related arteries. Material and methods: 176 consecutive patients admitted with acute coronary syndrome (ACS) with ST-segment elevation were analyzed. Four groups were compared. Group 1 (n =41): no residual coronary artery disease. Group 2 (n =36): with no significant residual coronary artery disease. Group 3 (n =72): with significant residual coronary artery disease. Group 4 (n =23) with chronic occlusion of at least one coronary artery. Results: Strong predictors of mortality were group 4 (OR: 5.76, 95% CI: 2.2-14.7, P <0.001) and the occurrence off ailed angioplasty (OR12, 95% CI 4-36, P <0.001).Groups 1,2 and 3 had similar mortality rates to each other but significantly different over all and separately for group 4. Multivariate analysis identified as the best independent predictors of mortality per month the failed angioplasty (OR: 8.3, CI:2.4-28, p<0.001), KK functional class IV(OR: 7.2, CI:2.6-20; p: 0.001) and chronic total occlusion (OR3.4:CI1044-10, p = 0.03). Conclusions: Chronic total occlusion of non-infarct-related artery was associated with in creased risk at admission, lower reperfusion rate and increased 30-day mortality.