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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
MIRANDA-ARBOLEDA, Andrés F. et al. Predictors of mortality in patients with coronary artery disease and involvement of the left main artery. Rev. Colomb. Cardiol. [online]. 2022, vol.29, n.6, pp.629-639. Epub Dec 27, 2022. ISSN 0120-5633. https://doi.org/10.24875/rccar.22000023.
Introduction:
involvement of the unprotected left main coronary artery (TPInp) in patients with coronary artery disease (CAD) leads to a high risk of cardiovascular events. Coronary artery bypass grafting (CABG) has been the standard of management; however, recent studies propose percutaneous coronary intervention (PCI) as an alternative treatment.
Objective:
to evaluate the in-hospital and follow-up outcomes of patients with compromised TPInp.
Method:
retrospective multicenter observational cohort study, we evaluated patients with CAD and TPI involvement. Death from any cause, nonfatal myocardial infarction, stroke, reoperation, and/or hospital readmission were assessed as a composite endpoint and individually during hospitaliza- tion and follow-up time.
Results:
82 patients were included, mean age 71 ± 9.9 years; 35 received PCI, 31 CABG, and 16 medical management (MM). In-hospital mortality was 16%. In the mean follow-up of 12.3 months, mortality was 20%, rein- farction 6% and hospital readmission 4%. The incidence rate of death was 5.19 per 10,000 people/day for MM, 2.3 per 10,000 people/day for PCI, and 1.06 per 10,000 people/day for CABG; at follow-up, mortality was higher in the PCI group (HR 3.6; 95%CI 1.13-11.9; p = 0.02). Elevated heart rate on admission was associated with higher mortality (p < 0.05).
Conclusion:
TPInp involvement is associated with a high risk of death and presents with complex coronary anatomy.
Keywords : Left main coronary artery disease; Percutaneous coronary intervention; Coronary artery bypass graft surgery.