BACKGROUND: A stenosis of left main coronary artery has critical prognostic importance. Recent reports on successful left main stenting are now challenging traditional treatment patterns for this lesion. We evaluated recent four-year trends in incidence, clinical, angiographic findings and treatment modalities in patients with left main coronary artery stenosis(LMS). METHODS: Patients who were diagnosed as a significant LMS at Yonsei cardiovascular hospital between 1996 and 1999 were analyzed retrospectively. RESULTS: The incidence of LMS during the period of 1996 to 1999 was 3.3%(n=24) and it was significantly higher than that of previous 15 years before 1996(p<0.01). The incidence of isolated ostial lesion was 0.28% and this lesion was more prevalent in young female patients with less risk factors compared with other types of LMS(p<0.01). After exclusion of the patients with an isolated ostial lesion, patients were grouped according to the lesion site: ostium, shaft, and shaft lesion extended to distal vessels. There were no differences in clinical and hemodynamic findings among these groups. Coronary artery bypass graft was performed in 141 patients(63%) and stent implantation in 16 patients(14%). CONCLUSION: The incidence of LMS has been increased. There was no difference in clinical and hemodynamic findings according to the types of LMS. Surgery is still a standard treatment, but in selected patients percutaneous coronary intervention can be another treatment option.
Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Hemodynamics ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stents ; Transplants

BACKGROUND: Stomach cancer is the most common cancer in Korea. Lifelong health management program recommends that males over 40 years and women over 50 years should undergo stomach cancer screening by endoscopy or upper gastrointestinal series every two years. The importance of re-screening of stomach cancer in a high risk group is emphasized. METHODS: A telephone questionnaire was done one year after to 123 patients over 40 years old considered as a high risk group with either chronic atropic gastritis, intestinal metaplasia, gastric ulcer, gastric adenoma among 804 subjects who had undergone anendoscopic examination from February 2002 to June 2003 at a university hospital health promotion center. RESULTS: The number of patients who responded were 109. The average recognition rate of high risk group was 53.2%. The rate of recognition of high risk group was lower in good subjective health estimation group and in less educated group, in old age group, and in chronic atrophic gastritis and intestinal metaplasia group. The rate of not receiving re-screening after 1 year was 48 (44.0%). Re-screening rate in patients with intestinal metaplasia (35.3%) and chronic atropic gastritis (39.1%) compared to gastric ulcer (77.8%) and gastric polyp (90.0%), in those not recognizing themselves as high risk group, in low education group, in old age, was lower. CONCLUSION: In patients with chronic atropic gastritis and intestinal metaplasia, in those not recognizing themselves as high risk group, in old age and in good subjective health state. We need to educate the importance for regular screening of stomach cancer more intensively.
Adenoma ; Education ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Health Promotion ; Humans ; Korea ; Male ; Mass Screening* ; Metaplasia ; Polyps ; Stomach Neoplasms* ; Stomach Ulcer ; Telephone ; Surveys and Questionnaires