Four-year outcomes after percutaneous coronary intervention of unprotected left main coronary artery disease in patients with stable angina and acute coronary syndrome

Abstract

Background: Percutaneous coronary intervention (PCI) of unprotected left main coronary artery disease (ULMCAD) have become a feasible and efficient alternative to coronary artery bypass surgery, especially in patients with acute coronary syndrome (ACS). There is limited data regarding early and late outcomes after ULMCAD PCI in patients with ACS and stable angina.The aim of this study was to compare early and four-year clinical outcomes in patients with ULMCAD PCI presenting as ACS or stable angina in a high-volume PCI center.Methods: We conducted a single center retrospective observational study, that included 146 patients with ULMCAD undergoing PCI between 2014-2018. Patients were divided in two groups: Group A included patients with stable angina (n=70, 47.9%) and Group B patients with ACS (n=76, 52.1%).Results: 30-day mortality was 8.22% overall, lower in Group A (1.43% vs 14.47%, p=0.02). Mortality and major adverse cardiac events (MACE) rates at 4 years were significantly lower in Group A (9.64% vs 33.25%, p=0.001, and 24.06% vs 40.11%, p=0.012, respectively). Target lesion revascularization (TLR) at 4 year didn’t differ between groups (15% in Group A vs 12.76% in Group B, p=0.5).Conclusions: In our study patients with ULMCAD and ACS undergoing PCI had higher early and long-term mortality and MACE rates compared to patients with stable angina, with similar TLR rate at 4-year follow-up.

Unprotected Left Main Bifurcation Stenting in Acute Coronary Syndromes: Two-Stent Technique versus One-Stent Technique

“…For all patients the electronic hospital records were reviewed, including angiography and angioplasty imaging. All clinical or angiographic characteristics were defined and classified as per current practice and guidelines [11,12,14]. Follow up was through in-hospital records (n = 38, 54.2%) or a combination of telephone interview by attending physician and the National Insurance Agency Platform (n = 32, 45.7%).…”

“…Therefore, there is a significant gap in knowledge regarding the treatment of patients with UDLMCAD in acute settings. There is little evidence guiding the choice between one-stent and two-stent approaches in UDLMCAD presenting as ACS [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. We aimed to compare these two techniques in an unselected ACS group.…”

Four-Year Outcomes of Unprotected Left Main Lesion PCI with Self-Apposing Stents versus Balloon-Expandable Stents

“…Six patients (4.1%) were on mechanical support system with IABP prior to the PCI procedure [12,13]. Radial access was used more often with self-apposing stents (19.4% in self-apposing Group vs 3.6% in balloon-expandable Group, p=0.004).…”

Serum brain‐derived neurotrophic factor in coronary heart disease: Correlation with the T helper (Th)1/Th2 ratio, Th17/regulatory T (Treg) ratio, and major adverse cardiovascular events

“…[5][6][7] Unfortunately, the 4-year MACEs rate ranges from 24.06% to 40.11%, implying that the clinical outcomes of many CHD patients are still not ideal. [8][9][10] Therefore, exploring some potential biomarkers is helpful for identifying disease risk and improving the clinical management of CHD.…”

“…), numerous interventions have been developed, which contain coronary revascularization, angiotensin inhibitor therapy, antiplatelet and lipid therapy, etc 5–7 . Unfortunately, the 4‐year MACEs rate ranges from 24.06% to 40.11%, implying that the clinical outcomes of many CHD patients are still not ideal 8–10 . Therefore, exploring some potential biomarkers is helpful for identifying disease risk and improving the clinical management of CHD.…”