Results and prognostic factors associated with percutaneous coronary interventions for unprotected left main coronary artery disease - 06/01/20
Résumé |
Background |
Unprotected left main coronary artery (ULMCA) disease is seen approximately 4% of patients who undergo angiography. Percutaneous coronary intervention (PCI) is an accepted alternative to surgery for the treatment of this disease.
Purpose |
Aim of our study is to evaluate the results of our experience in ULMCA PCI and assess prognostic factors associated with such procedures.
Methods |
Between January 2005 and August 2016, 109 consecutive procedures of LMCA PCI were assigned retrospectively. Clinical variables, the reasons for cardiac catheterization, therapeutic decisions and clinical evolution in long-term follow-up were analyzed.
Results |
The mean age of our population was 62.27±10.68 years and predominantly male (72%). Diabetes mellitus was found in 63 patients (58%). Presentation on admission was mainly stable angina in 40 patients (37%). True bifurcation lesions (Medina 1-1-1 and 1-0-1) were present in 56 distal LMCA patients (51%). Triple vessel disease was associated in 21 patients (19%). The Syntax score was <32 in 83%. The procedure was elective in 86% (n=93). Drug eluting stents were used in 84%. For distal LMCA, PCI technique was provisional T stenting in 90%. Angiographic success was achieved in 92% and procedural success in 90%. The in-hospital mortality rate was 4.5% (n=5). After a mean follow up of 39.7±26.8 months, the rate of MACE was 29% (cardiac death: 5.7%, myocardial infarction: 10.57%, TLR: 12.5%). The rate of acute stent thrombosis was 0.9% (n=1). The syntax score, urgent PCI and distal ULMCA PCI was significantly associated with MACE (P=0.04, P=0.036, P=0.006 respectively). Diabetes mellitus and the bare metal stents were the only two independent factors associated significantly with TLR (P=0.03 and P=0.04 respectively).
Conclusion |
The results of our growing experience in LMCA PCI are encouraging with high rate of procedural success and acceptable medium and long-term results.
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Vol 12 - N° 1
P. 21 - janvier 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.