Characteristics and long term outcomes of patients with acute coronary syndromes due to culprit left main coronary artery disease treated with percutaneous coronary intervention

American Heart Journal
S Michael GharacholouMandeep Singh

Abstract

Patients with acute coronary syndrome (ACS) due to unprotected culprit left main coronary artery disease (LMCAD) treated with percutaneous coronary intervention (PCI) are rare, high-risk, and not represented in trials. Data regarding long term outcome after PCI are limited. Between January 2000 and December 2014, there were 8,794 patients hospitalized with unstable angina/non-ST elevation myocardial infarction (UA/NSTEMI) or ST-elevation myocardial infarction (STEMI) treated with PCI at our institution; of these, 83 (0.94%) patients were identified as having culprit LMCAD ACS. Of the 83 patients with unprotected LMCAD ACS, 40 patients presented with STEMI and 43 patients presented with UA/NSTEMI. As compared to LM UA/NSTEMI, LM STEMI patients were younger and had less hypertension, with a trend towards greater frequency of cardiogenic shock. Distal LM involvement was common in both groups and did not differ by ACS type. In-hospital mortality was 33% in LM STEMI and 9% in LM UA/NSTEMI (P = .009). Over median follow up of 6.3 years, long term survival rates in both groups were similar (46% for STEMI vs 51% for UA/NSTEMI; P = .50 by log-rank). Unprotected culprit LMCAD ACS necessitating PCI is uncommon, occurring in <1% of cases, ...Continue Reading

Citations

Sep 13, 2019·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Dawid L StaudacherConstantin von Zur Muehlen
Feb 29, 2020·Minerva cardioangiologica·Mauro Chiarito, Julinda Mehilli
Mar 23, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Naoki ShibataUNKNOWN N-Registry Investigators
Mar 21, 2020·International Journal of Cardiology·Julian YeohUNKNOWN Melbourne Interventional Group
May 25, 2021·The International Journal of Angiology : Official Publication of the International College of Angiology, Inc·Mohamed A OmerTahir Tak

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.