[Stenosis of the common trunk with and without ostium involvement: clinical and angiographic characteristics].
OBJECTIVE
To evaluate the clinical and angiographic profile of patients with left main coronary artery stenosis with (LM-OS) and without left coronary ostial stenosis (LM-NOS).


METHODS
Retrospective study of patients submitted to coronary angiography.


METHODS
Laboratory of Hemodynamics and Interventional Cardiology at Bellvitge Hospital -Barcelona, Spain.


METHODS
4663 consecutive patients (pts) with angiographically defined coronary artery disease. 139 pts had left main stenosis greater than or equal to 50%. Twelve pts were excluded because nonatheroesclerotic disease. Twenty two pts (17%), had LM-OS and 105 (83%) LM-NOS.


METHODS
Pts records were reviewed, to analyse the following clinical and angiographic variables: age, gender, risk factors to coronary artery disease, history of myocardial infarction, anginal class, presence of unstable angina, basal ECG ischemia, percentage and localization of left main stenosis, number and degree of vessels diseased, indexes of left ventricular function and coronary dominance.


RESULTS
1. Clinical characteristics--In the LM-OS group 18 pts were male and 4 female, while in the LM-NOS the numbers were respectively 90 and 15, p = ns. As for the gender the age showed also a similarity: 58 +/- 8 and 57 +/- 8 years, p = ns. A history of arterial hypertension was present in 73% of pts with LM-OS and 47% with LM-NOS, p greater than 0.05. With respect to the other clinical variables both groups were similar. The incidence of LM-OS was 0.4%. 2. Angiographic characteristics--The severity of left main stenosis was identical in the two groups: 80 +/- 15 in LM-OS and 75 +/- 16% in LM-NOS (p = NS). Four (18%) of the pts with LM-OS had no associated coronary disease versus 7 (7%) of the LM-NOS (p = 0.08). There were 1.3 +/- 1 diseased vessels in the LM-OS group and 2.1 +/- 1 in the LM-NOS (p greater than 0.01).


CONCLUSIONS
In the present series, the clinical and hemodynamic profile of patients with left main disease suggest that the following characteristics are more frequently seen in patients with ostial stenosis: 1) history of arterial hypertension; 2) no associated coronary disease; 3) smaller number of diseased vessels; 4) less significant stenosis.
Bernardes
L
L
Interno de Cardiologia do Hospital Santa Marta.
Patrício
L
L
Cequier
A
A
Mauri
J
J
Sala
J
J
Esplugas
E
E
D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies
Estenose do tronco comum com e sem envolvimento do ostium: características clínicas e angiográficas.