Unprotected Left-Main Coronary Angioplasty in the Elderly in a High Volume Catheterization Centre without On-Site Surgery Facilities: Immediate and Medium Term Outcome—The Old-Placet Registry

Abstract

We aim to assess clinical feasibility and efficacy of unprotected left main (ULM) percutaneous coronary intervention (PCI) in patients older than 75 years over a 6-year period and with 2-year follow-up demonstrating that PCI is a feasible revascularization strategy even in absence of on-site cardiothoracic support. Nevertheless, the outcome of these high-risk patients is still hampered by a sensible in-hospital mortality rate. Older patients have a higher mortality at follow-up (10.0 versus 0.8%, P = 0.014), while younger patients have a low mortality after the acute phase (15.7 versus 8.4%, P = 0.15).

Long-term prognosis of patients with acute myocardial infarction due to unprotected left main coronary artery disease: a single-centre experience over 14 years

“…(2,5) Similarly, Gagnor et al also reported that the rate of adverse events in patients after discharge was low. (6) However, the Kaplan-Meier survival curve did not show similar results in the present study. This may be related to differences in follow-up time.…”

“…In the study by Parma et al, follow-up time was 15.8 ± 10.9 months, with a median of only 14 months. (5) The follow-up times of the studies carried out by Izumikawa et al and Gagnor at al were also only 1.7 ± 2.9 years and 504 ± 653 days, respectively, (2,6) which was substantially shorter than the follow-up time in the current study, which was 44.6 ± 31.3 (median 60) months.…”

“…In addition, follow-up durations reported in previous published research were short and therefore cannot show the long-term prognosis of these patients. (4)(5)(6) In the present study, we analysed the short-and long-term prognoses of patients with AMI due to ULMCA disease as well as the predictors of these prognoses. Only AMI patients whose infarct-related artery (IRA) was the ULMCA, as confirmed by angiography, were enrolled and long-term follow-up was performed.…”

Clinical outcomes after percutaneous or surgical revascularisation of unprotected left main coronary artery-related acute myocardial infarction: a single-centre experience

“…Reviewing the literature, there is a worldwide variety in the management of PPCI of ULMCA concerning drug-eluting stent (DES) or bare metal stent (BMS) use. Most of the contemporary European, Australian and Japanese studies reported dominant BMS8 17 or mixed BMS/DES1 3 16 18 21 use, while in the Korean studies, most PPCIs of the ULMCA were performed with DES 9 14 19. Previous large meta-analyses comparing DES with BMS in patients with stable angina/acute coronary syndromes38 and STEMI39 consistently showed no benefit of DES concerning death or MI, whereas revascularisation rates were significantly lower with DES.…”

Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft in Aged Patients With Unprotected Left Main Artery Lesions

“…Different studies demonstrated a relatively high in-hospital mortality despite successful primary PCI in the subset of the population, which ranged from 16-38%. [24][25][26][27] The LM as infarct artery without collateral branches or a coronary bypass graft usually causes a large area of ischemia and deteriorates the left ventricular function. Afterwards, cardiac function is susceptible to a second strike as soon as the coronary flow recovers, namely reperfusion injury.…”