Outcomes of primary percutaneous intervention of the unprotected left main coronary artery stenosis in myocardial infarction
| Autor: | Mehiar El-Hamdani, Silvestre Cansino, Hany Guirgis, Todd Gress, Mark Studeny, Yousef Hadi Darrat |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Left Main Coronary Artery Stenosis Kaplan-Meier Estimate Percutaneous Coronary Intervention Internal medicine medicine Risk of mortality Humans cardiovascular diseases Myocardial infarction Survival rate Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Hazard ratio Coronary Stenosis Stent General Medicine Middle Aged medicine.disease Survival Rate Stenosis Treatment Outcome Conventional PCI Cardiology Female Stents business |
| Zdroj: | Southern medical journal. 105(11) |
| ISSN: | 1541-8243 |
| Popis: | Objective The aim of our study was to examine the 30-day and 1-year survival rate for patients undergoing percutaneous coronary artery intervention (PCI) of unprotected left main (ULM) stenosis by the presence (acute myocardial infarction [AMI] group) or absence (non-AMI group) of AMI at the time of hospital admission. Methods We retrospectively reviewed 64 patients undergoing PCI of ULM stenosis at our regional heart institute between 2000 and 2008. Patients had no history of coronary artery bypass grafting. Results Thirty-six men and 28 women underwent PCI for ULM stenosis. Overall Kaplan-Meier survival at 30 days and 1 year was 71.5% and 57.8%, respectively. Thirty-three patients (51.6%) presented with AMI. Those with AMI had lower survival at both 30 days (59.2 vs 83.9%; P = 0.04) and 1 year (45.2 vs 70.2%; P = 0.04) compared with those without AMI. Compared with a lesion involving only the ostial/mid LM, diffuse disease (N = 11) was associated with an increased mortality at 1 year (hazard ratio 0.27; 95% confidence interval 0.09-0.79). A stent size >3 mm was associated with lower mortality at 1 year (hazard ratio 0.42; 95% confidence interval 0.19-0.93). Conclusions We found that AMI at presentation was significantly associated with higher mortality in patients undergoing ULM stenting. LM lesion location and stent size were both significantly associated with mortality. ULM stenting is an option in patients who are unable to undergo coronary artery bypass grafting, but patients should understand the overall high risk of mortality, particularly if they present with AMI. |
| Databáze: | OpenAIRE |
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