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Long-term clinical outcomes after unprotected left main coronary artery stenting in an all-comers patient population

Mohammed Ali1, Alan Hanley, Brendan McAdam

  • 1Department of Cardiology, Beaumont Hospital, Ireland.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 14, 2013
PubMed

Insights

Percutaneous coronary intervention stenting of unprotected left main coronary artery stenosis is safe and effective for improving survival in high-risk patients. This study demonstrates favorable long-term outcomes in a real-world setting.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Technology

Background:

  • Coronary artery disease treatment aims to enhance survival and alleviate symptoms.
  • Left main coronary artery (LMCA) stenting and coronary-artery bypass grafting (CABG) safety and efficacy have been compared in numerous studies.
  • Unprotected LMCA stenosis poses significant risks, necessitating effective treatment strategies.

Purpose of the Study:

  • To evaluate the long-term outcomes of stenting unprotected LMCA stenosis in routine clinical practice.
  • To assess the safety and efficacy of percutaneous coronary intervention (PCI) for unprotected LMCA stenosis in unselected patients.
  • To analyze major adverse cardiac events (MACE) in patients undergoing unprotected LMCA stenting.

Main Methods:

  • A prospective registry of 158 patients with symptomatic unprotected LMCA stenosis undergoing PCI.
  • Surgical mortality risk estimated using the euroSCORE.
  • Primary endpoint: MACE (cardiac death, nonfatal myocardial infarction, target lesion revascularization) at follow-up.

Main Results:

  • Mean follow-up was 54 ± 25 months.
  • The overall MACE rate was 11.4%.
  • Cardiac death occurred in 12 patients (7.6%), with higher rates in patients with elevated euroSCORE (21.6 ± 5.5, P < 0.001).
  • In-stent restenosis occurred in 4.4% of patients.

Conclusions:

  • Stenting of unprotected LMCA stenosis is safe and clinically effective in high-risk patients.
  • The procedure helps maintain event-free survival in the long term.
  • This ongoing registry supports PCI as a viable treatment option for unprotected LMCA stenosis.
Abstract

Keywords:
MACEacute coronary syndromebare metal stentsdrug eluting stentseuroSCOREleft main coronary artery percutaneous intervention

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