Left main percutaneous coronary intervention in ACS or stable coronary artery disease: acute and long-term results
| Autor: | Elisabetta, Varani, Sabine, Vecchio, Matteo, Aquilina, Giuseppe, Vecchi, Marco, Balducelli, Valeria, Frassineti, Massimo, Margheri |
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| Rok vydání: | 2016 |
| Předmět: |
Aged
80 and over Male Time Factors Coronary Stenosis Coronary Artery Disease Middle Aged Prognosis Percutaneous Coronary Intervention Treatment Outcome Multivariate Analysis Humans ST Elevation Myocardial Infarction Female Angina Unstable Hospital Mortality Acute Coronary Syndrome Non-ST Elevated Myocardial Infarction Aged Retrospective Studies |
| Zdroj: | Minerva cardioangiologica. 64(1) |
| ISSN: | 1827-1618 |
| Popis: | The aim of this study was to assess in-hospital and long-term results of the novo unprotected left main (UPLM) percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) or stable coronary artery disease (CAD), in an unselected population admitted to a single high- volume cath-lab without on-site cardiac surgery.From 2008 to 2011, among 317 PCI performed in patients with the novo UPLM stenosis, 49 patients presented ST-elevation myocardial infarction (STEMI), 152 non ST-elevation MI/unstable angina (NSTEMI/UA), 116 stable CAD.In-hospital mortality was 20% in STEMI, 5.3% in NSTEMI/UA and 1.7% in stable CAD patients (P0.001). Two-year total mortality was 24.5%, 25.6% and 6% in the 3 groups, and cardiac death was 20%, 13.8% and 3.4% (P=0.002). Left main target lesion revascularization (TLR) was similar in the 3 groups, as the clinically-driven TLR (10% vs. 11% vs. 7.7%, P=0.642), with neither definite nor probable stent thrombosis. Multivariate analysis showed the following independent predictors of 2-year mortality: bare-metal stent use (OR 4.53, P0.001), Syntax Score32 (OR 3.53, P=0.012), ACS as the indication (OR 3.24, P=0.012), peripheral artery disease (OR 2.20, P=0.042), and age75 years (OR 2.09, P=0.05).Our experience showed acceptable results of UPLM PCI in STEMI patients, where short-term prognosis was related to hemodynamic conditions, good results in NSTEMI/UA patients where mortality increased in the follow-up due to comorbidities, and very good results in patients with stable CAD. |
| Databáze: | OpenAIRE |
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