0293: Predictors of major cardiovascular events during unprotected left main PCI

Abstract

PCI has become increasingly practiced in left main stenosis (LMS). The purpose of this study was to determine predictors of mid term major cardiovascular events in 110 cases of unprotected left main PCI. Clinical and angiographic data were collected retrospectively for all patients with LMS, admitted to the cardiology center of Sfax between 2002 and 2013 and for which urgent or scheduled percutaneous revascularization was performed. The occurrence of cardiovascular events, or MACCE: death, MI, heart failure, angina or stroke recurrence was assessed at 12 months. During the study period, 110 patients underwent an unprotected LM PCI. These patients were predominantly male (72.7%). The death rate intra – hospital was 4.5% and 12 months mortality was 3.6%. 31 patients (28.2%) had nonfatal events during follow up. The clinical presentation at admission and diabetes were MACCE predictors at 12 months (p=0.04 and 0.05 successively). The distal LM location with bifurcation involvement, the multivessel disease associated and a high Syntax score> 32 are predictors of the occurrence of MACCE in the medium term (p=0,03; p=0001; and p=0001 successively). The type and length of the stent used in the LMS are also predictors of the occurrence of MACCE (49.1% for BMS versus 9.8% for DES, p<0.001). The unprotected LM PCI became promising thanks to developpemet of angioplasty techniques and equipement especially intracoronary imaging.