Impact of urgent and elective percutaneous coronary intervention on outcomes of patients with left main coronary artery bifurcational stenosis
- VernacularTitle:Зүүн титмийн баганын салааны нарийсалд яаралтай болон төлөвлөгөөт журмаар титэм судсан дотуурх эмчилгээ хийсэн үр дүн
- Author:
Bum-Erdene Batbayar
1
;
Oyunkhand Buyankhishig
2
;
Gereltuya Choijiljav
2
;
Surenjav Chimed
3
;
Lkhagvasuren Zundui
4
;
Batmyagmar Khuyag
2
Author Information
1. First State Central Hospital, Ulaanbaatar, Mongolia
2. Intermed hospital, Ulaanbaatar, Mongolia
3. Leiden university medical center, Leiden, Netherlands
4. Third state central hospital, Ulaanbaatar, Mongolia
- Publication Type:Journal Article
- Keywords:
CHIP;
left main coronary artery;
bifurcational stenosis;
PCI;
outcome
- From:Mongolian Medical Sciences
2021;198(4):33-39
- CountryMongolia
- Language:Mongolian
-
Abstract:
Introduction:Left main coronary artery (LMCA) is a large vessel which supplies the majority of left ventricle and
critical lesion at the bifurcation of LMCA can lead to life threatening condition. Therefore, percutaneous
coronary intervention (PCI) on LMCA bifurcational stenosis is considered as a complex high risk
indicated patient and procedure (CHIP).
Goal:In this study, we investigated the impact of urgent and elective PCI on outcomes of patients with
LMCA bifurcational stenosis.
Materials and Methods:Patients who underwent for urgent PCI due to acute myocardial infarction (AMI) or elective PCI due
to stable coronary artery disease (CAD) for their LMCA bifurcational stenosis. Any lesion with >50%
stenosis on coronary angiography was considered as a critical stenosis. LMCA bifurcational stenosis
was evaluated by Medina classification. Difference between urgent and elective PCI group were
compared by independent sample t-test and chi-square test. Association between treatment strategy
(urgent or elective PCI) and prognosis were evaluated by Cox proportional hazard regression, and
survival rate was evaluated by Kaplan-Meier methods. Ethical approval was taken from the ethical
committee of the Health Science University of Medical Sciences (№30/1А) in June 12, 2012.
Results:A total of 82 patients with LMCA bifurcational stenosis were included (mean age 62±11, male 76.8%)
and 14 of them underwent urgent PCI due to AMI and 68 of had elective PCI due to stable CAD.
Patients who underwent urgent PCI had significantly higher 30-day mortality (1.5% vs. 21.4%, p<0.05)
and all-cause mortality (7.4% vs. 35.7%, p<0.003) compared to the elective PCI group. Urgent PCI
for LMCA bifurcational stenosis due to AMI was associated with increased risk of death (HR=3.63, 95% CI 1.02-12.9, p<0.05). Kaplan-Meier estimation showed that patients in the urgent PCI group
had significantly lower survival compared to the elective PCI group.
Conclusion:Unanticipated urgent PCI for patients with LMCA bifurcational stenosis due to AMI is associated with
higher risk of short and long-term mortality. Patients who underwent urgent PCI for LMCA bifurcational
stenosis had significantly lower survival compared to elective PCI group.
- Full text:2021-198(4)-33-39.pdf
