Abstract
Objectives: To study left main registry for Indian population, demographic and procedural characteristic of patient outcomes after unprotected left main percutaneous coronary intervention (uLMPC) and identify the predictors of prognosis. Methods: A total of 109 consecutive patients, who underwent uLMPCI, were analyzed in this single-center registry. All data related to the patient's clinical presentation, procedure and follow-up were collected. Syntax score and medina score were calculated for all patients. Mean follow-up duration of the study was 1 year. Procedural success rate for left main intervention was 100%. Primary endpoint was composite of major adverse cardiovascular and cerebrovascular events (MACCE), including cardiac death (CD), cerebrovascular accident (CVA), myocardial infarction (MI), and need for repeat revascularization and intervention. Results: There was no primary end point noted in our study. Overall one year MACCE-free survival rate was 100%. Secondary end points were seen in 9 (8.2%). Secondary end point were lower in non diabetic patients who underwent uLMPCI with left main alone intervention, single stent in a vessel. Patients with syntax score ≤ 32 had higher event-free secondary end point rate than those with syntax score >32 . Syntax score >32 was found to be significantly correlated to prior PCI/CABG patients, patients with multiple stenting and multiple vessel stenting. Syntax score >32 was the only independent predictor of adverse outcome. Conclusion: uLMPCI is safe and effective treatment alternative to CABG in non diabetic patients with selected LM alone, single vessel and single stent patients with low and intermediate syntax score (≤ 32).
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