The Comparing of Short Clinical Cardiovascular Outcomes with Wraparound and Nonwraparound Left Anterior Descending
Hassan Shemirani1, Reihaneh Zavar1, Alireza Khosravi1
1Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Patients with anterior ST-segment elevation myocardial infarction (STEMI) and a wraparound left anterior descending artery (LAD) experience worse outcomes. Understanding LAD anatomy is crucial for patient care and treatment strategies.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Anatomy
Background:
- The relationship between left anterior descending artery (LAD) anatomy and outcomes in anterior ST-segment elevation myocardial infarction (STEMI) is not well-established.
- Anterior STEMI patients undergoing primary percutaneous intervention (PCI) require further investigation into the impact of LAD variations.
Purpose of the Study:
- To investigate the frequency and severity of short-term cardiovascular outcomes in anterior STEMI patients.
- To compare outcomes based on the presence of a wraparound versus non-wraparound LAD anatomy.
Main Methods:
- A cross-sectional study of 126 anterior STEMI patients admitted in 2020.
- Evaluation of LAD coronary artery anatomical features and clinical outcomes during hospitalization and up to one month post-PCI.
Main Results:
- Wraparound LAD prevalence was 73% in the study population.
- Severe left ventricular systolic dysfunction was significantly higher in the wraparound LAD group (39.6%) compared to the non-wraparound group (8.8%) (P < 0.001).
- Arrhythmia frequency was also higher in the wraparound LAD group (21.7%) versus the non-wraparound group (5.9%) (P = 0.037).
Conclusions:
- Anterior STEMI patients with a wraparound LAD exhibit poorer clinical outcomes and more severe left ventricular systolic dysfunction.
- Assessing LAD artery anatomy during angiography is critical for optimizing patient management and treatment.
Background:
The relation between left anterior descending artery (LAD) anatomy and clinical outcomes in patients with anterior ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. The aim of this study was to determine the frequency and severity of short-term cardiovascular outcomes in patients with Anterior ST-Segment Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous intervention (PCI), based on wraparound and non-wraparound left anterior descending artery (LAD).
Methods:
In a cross-sectional study, 126 patients with anterior STEMI who were admitted to Shahid Chamran Hospital in Isfahan during 2020 were studied. Patients were evaluated for anatomical features of LAD coronary artery and clinical outcomes determined and compared based on wraparound LAD and non-wraparound LAD during hospitalization and up to one month after PCI.
Results:
The prevalence of wraparound LAD in the studied patients was 73% and left ventricular systolic dysfunction in admission was greater and more severe in patients with wraparound LADs compared with those with non-wraparound. Severe LV systolic dysfunction in the wraparound and non-wraparound groups was 39.6% and 8.8%, respectively (P < 0.001). Also, the frequency of arrhythmias in the wraparound group (21.7%) was higher than the non-wraparound group (5.9%) (P = 0.037).
Conclusion:
The patients with anterior STEMI and wraparound LAD have a worse clinical outcome and more severe left ventricular systolic dysfunction. Therefore, it seems that the study of the anatomical condition of the LAD artery at the time of angiography is of great importance in the way of observation and care, and treatment of patients.
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