Related Experiment Video
Updated: Jul 3, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
One-year outcomes of left main coronary artery stenting in patients with cardiogenic shock
Insights
Coronary interventions reduce cardiogenic shock mortality. However, left main coronary artery disease angioplasty showed high periprocedural deaths and restenosis rates, necessitating close follow-up.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- In-hospital mortality for cardiogenic shock is decreasing due to coronary interventions.
- Left main coronary artery (LMCA) disease is a critical condition often leading to cardiogenic shock.
Purpose of the Study:
- To evaluate the outcomes of angioplasty and stenting in patients with cardiogenic shock caused by LMCA disease.
- To assess periprocedural and late mortality, restenosis, and re-intervention rates.
Main Methods:
- A cohort of 71 patients with LMCA disease (38 with cardiogenic shock, 33 without) underwent emergency angioplasty and stenting.
- Clinical and angiographic follow-up was conducted for one year to assess outcomes.
Main Results:
- Overall mortality was 23.9%. One-year survival in the cardiogenic shock group was 57.9%, with most deaths occurring periprocedurally.
- Restenosis rates were 29.4% in the shock group and 16.0% in the non-shock group.
- Predictors of cardiogenic shock included STEMI and small minimal lumen diameter; small post-procedure lumen diameter predicted death in shock patients.
Conclusions:
- High mortality, particularly in cardiogenic shock patients, was observed following LMCA angioplasty and stenting.
- Most deaths were periprocedural, highlighting the acute risks.
- Frequent angiographic follow-up is recommended due to high restenosis rates, especially within the first six months post-stenting.
Background:
The high in-hospital mortality of patients with cardiogenic shock is being reduced thanks to coronary interventions. The aim of the study was to evaluate the outcomes of angioplasty and stenting in patients with cardiogenic shock caused by left main coronary artery (LMCA) disease.
Methods:
A group of 71 consecutive patients managed for LMCA disease in an emergency setting (38 patients in cardiogenic shock and 33 without shock symptoms) were followed up clinically and angiographically for one year. Periprocedural and late mortality was assessed as well as the incidence of restenosis and coronary re-interventions.
Results:
There were 17 deaths in the study population (23.9%). One-year survival in the subgroup with cardiogenic shock was 57.9% (22 patients) with 15 periprocedural deaths and 1 death 3 months after the procedure. Restenosis and associated target lesion revascularization were documented in 5 patients (29.4%) with and 4 patients (16.0%) without cardiogenic shock. Multivariate analysis revealed the following independent predictors of cardiogenic shock in patients undergoing emergency LMCA angioplasty: STEMI as the reason for intervention (OR 14.1; 95% CI 3.71-53.7; p < 0.0002) and a small minimal lumen diameter before the procedure (OR 0.43; 95% CI 0.2-0.93; p < 0.04). The only independent predictor of the death in patients with cardiogenic shock was a small minimal lumen diameter after the procedure (OR 0.31; 95% CI 0.1-0.99, p < 0.05).
Conclusions:
High mortality was observed in the study population, especially in the subgroup with cardiogenic shock. Most deaths were periprocedural. Because of the high rate of restenosis, periodical angiographic follow-up is necessary, preferably twice in the first 6 months after stent implantation. (Cardiol J 2007; 14: 67-75).
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:22Mitral Stenosis I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies