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Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Long-Term Follow-Up of Patients With Isolated Side Branch Coronary Artery Disease
Sukru Arslan1, Ahmet Yildiz2, Okay Abaci2
1Department of Cardiology, Cardiology Institute of Istanbul University-Cerrahpasa, Gaziosmanpasa Taksim Egitim ve Arastirma Hastanesi, Istanbul, Turkey.
Insights
Long-term outcomes for isolated side branch coronary artery disease (CAD) show clinical risk factors, not lesion morphology, predict major adverse cardiac and cerebrovascular events (MACCEs). Managing these factors is crucial for patient health.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Stable coronary artery disease (SCAD) research primarily focuses on main vessel disease.
- Limited long-term outcome data exists for isolated side branch coronary artery disease (CAD).
Purpose of the Study:
- To evaluate long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients with isolated side branch CAD.
- To identify predictors of MACCEs in this patient population.
Main Methods:
- Retrospective analysis of 437 patients with isolated side branch SCAD.
- Median follow-up of 38 months.
- Assessment of angiographic features and clinical risk factors.
Main Results:
- Overall MACCE rate was 14.6%, with 5.9% all-cause mortality.
- Independent predictors of MACCE included age, ostial lesions, glycated hemoglobin A1c, and neutrophil levels.
- Side branch location, vessel diameter, and lesion complexity did not significantly impact outcomes.
Conclusions:
- Clinical risk factors, rather than lesion morphology, are key predictors of MACCEs in isolated side branch CAD.
- Aggressive management of clinical risk factors is essential for improving outcomes in these patients.
Abstract:
The data with respect to stable coronary artery disease (SCAD) are mainly confined to main vessel disease. However, there is a lack of information and long-term outcomes regarding isolated side branch disease. This study aimed to evaluate long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients with isolated side branch coronary artery disease (CAD). A total of 437 patients with isolated side branch SCAD were included. After a median follow-up of 38 months, the overall MACCE and all-cause mortality rates were 14.6% and 5.9%, respectively. Among angiographic features, 68.2% of patients had diagonal artery and 82.2% had ostial lesions. In 28.8% of patients, the vessel diameter was ≥2.75 mm. According to the American College of Cardiology lesion classification, 84.2% of patients had either class B or C lesions. Age, ostial lesions, glycated hemoglobin A1c, and neutrophil levels were independent predictors of MACCE. On the other hand, side branch location, vessel diameter, and lesion complexity did not affect outcomes. Clinical risk factors seem to have a greater impact on MACCE rather than lesion morphology. Therefore, the treatment of clinical risk factors is of paramount importance in these patients.
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