Prognosis of Percutaneous Intervention of a Left Main Coronary Artery Stenosis Without the Use of Intravascular Imaging.

Mazhar Mahmood,Momin Salahuddin,Momin Khan,Hammad Shah,Karamat A Shah,Afrasyab Altaf

doi:10.7759/cureus.2857

Mazhar Mahmood, Momin Salahuddin + Show 4 more

Open Access

https://doi.org/10.7759/cureus.2857

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Abstract

ObjectivesThe aim of this study was to assess the prognosis in patients with left main coronary artery stenosis one year after percutaneous coronary intervention (PCI).MethodsOur study included 40 patients who underwent PCI for left main coronary artery stenosis without the use of intravascular ultrasound (IVUS). Patients were followed for a year, and the prognostic effect of PCI on a composite end-point of revascularization, new myocardial infarction, cardiac death, and on all-cause mortality was assessed in multivariable Cox analysis.ResultsThe multivariable analysis showed a good prognosis in patients receiving PCI with a total event rate of 7.5%. The independent predictors for major adverse cardiac events (MACE) were diabetes (p = 0.02). Other prognostic factors included in the model were gender, age, smoking, body mass index (BMI), hypertension, the complexity of the vessel, and ejection fraction.ConclusionPCI for left main coronary artery stenosis without the use of IVUS has a good prognosis after one year of clinical follow-up.

Highlights

Left main coronary artery disease (LMCAD) is associated with significant morbidity and mortality
Patients were followed for a year, and the prognostic effect of percutaneous coronary intervention (PCI) on a composite end-point of revascularization, new myocardial infarction, cardiac death, and on all-cause mortality was assessed in multivariable Cox analysis
Other prognostic factors included in the model were gender, age, smoking, body mass index (BMI), hypertension, the complexity of the vessel, and ejection fraction

Summary

Introduction

Left main coronary artery disease (LMCAD) is associated with significant morbidity and mortality. The relative risk of perioperative mortality for patients with significant LMCA stenosis compared with patients without LMCAD is 1.3. The five-year mortality in coronaryartery bypass grafting (CABG) patients with three-vessel disease is 10.7%, compared with 15.8%. How to cite this article Mahmood M, Altaf A, Salahuddin M, et al (June 22, 2018) Prognosis of Percutaneous Intervention of a Left Main Coronary Artery Stenosis Without the Use of Intravascular Imaging. CABG is recommended for most patients with LMCAD [5,6]

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