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Outcome of Percutaneous Coronary Intervention for Left Versus Non-left Main Coronary Artery in Acute Coronary

S M Mamun Iqbal1, A M Shafique2, Neuton Mondal1

  • 1Department of Cardiology, MH Samorita Hospital and Medical College, Dhaka, BGD.

Cureus
|October 3, 2025
PubMed

Insights

Patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) affecting the left main coronary artery (LMCA) face higher risks of adverse cardiovascular events, including myocardial infarction and repeat revascularization, compared to those with non-LMCA involvement.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Medicine

Background:

  • Acute coronary syndromes (ACS) involving the left main coronary artery (LMCA) are linked to significant morbidity and mortality.
  • Percutaneous coronary intervention (PCI) is a key treatment for ACS.
  • Outcomes of PCI for LMCA-ACS require further investigation.

Purpose of the Study:

  • To compare long-term outcomes of PCI in patients with ACS affecting the LMCA versus those with non-LMCA involvement.
  • To evaluate the incidence of major adverse cardiovascular events (MACE) and secondary endpoints post-PCI.
  • To identify risk factors associated with LMCA involvement in ACS.

Main Methods:

  • An interventional study involving 101 patients with ACS who underwent PCI.
  • Patients were divided into two groups: LMCA involvement (n=51) and non-LMCA involvement (n=50).
  • Follow-up assessments at 3, 6, and 12 months monitored MACE, persistent symptoms, repeat revascularization, and stent thrombosis.

Main Results:

  • The LMCA group had a higher MACE rate (6%) compared to the non-LMCA group (2%) (p=0.013).
  • Myocardial infarction (MI) occurred in 4% of the LMCA group, with no events in the non-LMCA group.
  • Higher rates of persistent symptoms and repeat revascularization were observed in the LMCA group.

Conclusions:

  • ACS involving the LMCA is associated with significantly higher rates of adverse cardiovascular outcomes after PCI.
  • PCI for LMCA-ACS necessitates careful consideration due to increased risks of MI and repeat revascularization.
  • Further research is warranted to optimize PCI strategies for LMCA-ACS patients.
Abstract

Keywords:
acute coronary syndromes (acs)cardiac deathleft main coronary artery (lmca)major adverse cardiovascular events (mace)percutaneous coronary intervention (pci)

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