Acute and long-term outcome of unprotected left main coronary angioplasty compared to the anticipated surgical risk
| Autor: | Harald Mudra, Markus Ferrari, Alexander Knape, Alexander Lauten, Hans R. Figulla, Julia Schumm, Wilma Rademacher |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Time Factors medicine.medical_treatment Kaplan-Meier Estimate Revascularization Risk Assessment Severity of Illness Index Coronary artery bypass surgery Germany Internal medicine Angioplasty medicine Humans Angioplasty Balloon Coronary Coronary Artery Bypass Aged Aged 80 and over business.industry Patient Selection Mortality rate Coronary Stenosis Percutaneous coronary intervention Stent Thrombosis EuroSCORE Middle Aged Surgery Treatment Outcome Cardiovascular Diseases Practice Guidelines as Topic Conventional PCI Cardiology Female Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interactive CardioVascular and Thoracic Surgery. 7:871-877 |
| ISSN: | 1569-9285 1569-9293 |
| DOI: | 10.1510/icvts.2008.178632 |
| Popis: | Percutaneous coronary intervention of unprotected left main (ULM) stenosis is increasing despite surgical revascularisation being the recommended treatment by the current guidelines. We compared the 30-day and 9-month mortality after ULM stenting with the predicted surgical outcome as determined by the EuroSCORE.We included 81 consecutive patients who underwent ULM stenting. The patient cohort was divided into a normal risk group (EuroSCOREor=5, predicted 30-day mortality3%), and a high-risk group (EuroSCORE5, predicted 30-day mortality 11%). Follow-up examinations were scheduled for one and nine months after the initial PCI. The average EuroSCOREs in the normal- and high-risk group were 3.0 (29 patients, 36%) and 10.0 (52 patients, 64%), respectively. Mortality rates at 30 days were 3% in the normal-risk group and 8% in the high-risk group. Subacute stent thrombosis occurred in 3.4% (three patients) undergoing elective PCI. Major adverse cardiac events during the nine months follow-up were registered in 24% of patients in the normal-risk group, and in 27% of the patients in the high-risk group.Short-term outcome of ULM stenting in our high-risk patients is comparable to surgical outcome predicted by the EuroSCORE. Long-term outcome was less favourable due to a high mortality rate. ULM stenting in patients with low surgical risk could be associated with higher mortality rates compared to CABG because of the unpredictable risk of a fatal stent thrombosis. |
| Databáze: | OpenAIRE |
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