Left Main Coronary Artery Disease—Current Management and Future Perspectives

Dąbrowski, Emil Julian; Kożuch, Marcin; Dobrzycki, Sławomir

doi:10.3390/jcm11195745

Cited by 12 publications

(9 citation statements)

References 126 publications

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“…Patients with LM occlusion are at an elevated risk of death due to its anatomic features and also because LM is responsible for supplying blood to 75–100% of the myocardium. Indeed, the LMCA was historically known as the “artery of sudden death” [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Cardiovascular Risk Factors and Coronary Angiographic Findings in High-Risk Immigrant Communities in Italy

Muscoli

Andreadi

Tamburro

et al. 2023

JPM

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Background: The prevalence of coronary artery disease (CAD) considerably varies by ethnicity. High-risk populations include patients from Eastern Europe (EEP), the Middle East and North Africa (MENAP) and South Asia (SAP). Methods: This retrospective study aims to highlight cardiovascular risk factors and specific coronary findings in high-risk immigrant groups. We examined the medical records and coronary angiographies of 220 patients from the above-mentioned high-risk ethnic groups referred for Acute Coronary Syndrome (ACS) and compared them with 90 Italian patients (IP) from 2016 to 2021. In the context of high-risk immigrant populations, this retrospective study aims to shed light on cardiovascular risk factors and particular coronary findings. We analyzed the medical records of 220 patients from the high-risk ethnic groups described above referred for ACS and compared them with 90 IPs between 2016 and 2021. In addition, we assessed coronary angiographies with a focus on the culprit lesion, mainly evaluating multi-vessel and left main disease. Results: The mean age at the first event was 65.4 ± 10.2 years for IP, 49.8 ± 8.5 years for SAP (Relative Reduction (ReR) 30.7%), 51.9 ± 10.2 years for EEP (ReR 26%) and 56.7 ± 11.4 years for MENAP (ReR 15.3%); p < 0.0001. The IP group had a significantly higher prevalence of hypertension. EEP and MENAP had a lower prevalence of diabetes. EEP and MENAP had a higher prevalence of STEMI events; SAP showed a significant prevalence of left main artery disease (p = 0.026) and left anterior descending artery disease (p = 0.033) compared with other groups. In SAP, we detected a higher prevalence of three-vessel coronary artery disease in the age group 40–50. Conclusions: Our data suggest the existence of a potential coronary phenotype in several ethnicities, especially SAP, and understate the frequency of CV risk factors in other high-risk groups, supporting the role of a genetic influence in these communities.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Cardiovascular Risk Factors and Coronary Angiographic Findings in High-Risk Immigrant Communities in Italy

Muscoli

Andreadi

Tamburro

et al. 2023

JPM

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“…Coronary artery disease (CAD) is a significant global health concern, especially when the left main coronary artery (LMCA) is affected. Interventional cardiologists face significant challenges when treating unprotected LMCA lesions, as they must make key revascularization technique decisions [1].…”

Section: Introductionmentioning

confidence: 99%

Intravascular ultrasound-guided percutaneous coronary intervention for patients with unprotected left main coronary artery lesions

Bendary,

Elsaed,

Tabl

et al. 2024

Coronary Artery Disease

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Background In percutaneous coronary intervention (PCI) procedures for patients with unprotected left main coronary artery (ULMCA) lesions, intravascular ultrasonography (IVUS) guidance has shown potential for enhancing clinical outcomes. However, studies confirming its superiority to conventional angiographic-guided PCI remain few. This study aimed to assess if IVUS-guided PCI for patients with unprotected LMCA stenosis improves clinical outcomes compared to angiographic-guided PCI. Methods This randomized clinical study enrolled 181 patients with ULMCA lesions scheduled for drug-eluting stent implantation. Patients were split into 90 in the IVUS-guided group and 91 in the conventional group. Procedural characteristics, clinical outcomes, and the incidence of major adverse cardiovascular event (MACE) were evaluated for all patients. The risk reduction associated with IVUS-guided PCI was evaluated using a multivariate Cox regression analysis. Results Patients who underwent IVUS demonstrated significantly higher pre-dilatation before stenting (88.9% vs. 72.5%, P = 0.005), post-dilatation balloon diameter (4.46 ± 0.48 vs. 4.21 ± 0.49, P < 0.001), stent diameter (3.9 ± 0.4 vs. 3.7 ± 0.3, P = 0.002), and pressure for post dilatation (18 ± 3 vs. 16 ± 2, P = 0.001). Regarding 12-month outcomes, patients who underwent IVUS demonstrated significantly lower MACE (3.3% vs. 18.7%, P < 0.001) than those who underwent the conventional method. Multivariate Cox regression analysis revealed that IVUS was related to 84.4% risk reduction of 1-year MACE (HR = 0.156, 95% CI = 0.044–0.556, P = 0.004). Conclusion Compared to angiographic-guided PCI, IVUS-guided PCI resulted in improved clinical results and a markedly reduced risk of MACE in patients with ULMCA lesions.

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“…PCI has been widely used in clinical practice because of its small trauma and remarkable curative effect. Patients with CHD and CHF are mostly elderly, and most of patients are frail in the body with severe vascular lesions, so they face a higher risk after surgery [3]. Moreover, patients are prone to various complications during the perioperative period, which affect their rehabilitation, so high-quality nursing work is particularly important in the treatment of CHD with CHF [4].…”

Section: Introductionmentioning

confidence: 99%

Exploration on the Value of Circulation Quality Control Intervention Mode in Percutaneous Coronary Intervention in Patients with Coronary Heart Disease and Chronic Heart Failure

Yang,

Ren,

Liu

et al. 2023

HSF

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Background: Patients with coronary heart disease (CHD) often have other diseases due to organ dysfunction, among which chronic heart failure (CHF) is the most common. Percutaneous coronary intervention (PCI) is the mainstream method for the treatment of such diseases. Because most of the patients are the elderly and the functions of various organs are declining, it is necessary to implement scientific and efficient management methods. Objective: To explore the application value of circulation quality control intervention (CQCI) mode in PCI of patients with CHD and CHF. Time: From June 2021 to June 2023. Methods: The clinical data of 197 CHD patients with CHF were retrospectively analyzed, and 14 patients who did not meet the inclusion criteria were excluded. According to different perioperative management methods, the remaining cases were divided into the reference group (RG, receiving routine clinical management) and observation group (OG, receiving routine clinical management and CQCI). The cardiac function indexes and emotional state before and after management were compared between the two groups, and the quality of life in two groups was compared. Results: In this study, 100 patients were included in the RG and 83 patients were included in the OG finally. Compared with the RG, the OG had lower levels of left ventricular end systolic diameter and left ventricular end-diastolic diameter after management (p < 0.05), while the OG had significantly higher left ventricular ejection fraction level (p < 0.001). The OG had overtly higher clinical satisfaction than the RG (p < 0.05). After management, the Hospital Anxiety and Depression Scale score in the OG were distinctly lower than those in the RG (p < 0.001). After management, the OG had significantly higher scores of physiological field, psychological field, social relationship and environmental field than the RG (p < 0.001). Conclusion: The application of CQCI mode in the perioperative period of PCI has certain benefits for improving the cardiac function of patients. At the same time, this program can also improve the quality of life of patients to a certain extent, which is helpful to accelerate postoperative rehabilitation.

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Left Main Coronary Artery Disease—Current Management and Future Perspectives

Cited by 12 publications

References 126 publications

Prevalence of Cardiovascular Risk Factors and Coronary Angiographic Findings in High-Risk Immigrant Communities in Italy

Prevalence of Cardiovascular Risk Factors and Coronary Angiographic Findings in High-Risk Immigrant Communities in Italy

Intravascular ultrasound-guided percutaneous coronary intervention for patients with unprotected left main coronary artery lesions

Exploration on the Value of Circulation Quality Control Intervention Mode in Percutaneous Coronary Intervention in Patients with Coronary Heart Disease and Chronic Heart Failure

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