title: One-year outcomes of left main coronary artery stenting in patients with cardiogenic shock.
abstract: BACKGROUND
  The high in-hospital mortality of patients with cardiogenic shock is being reduced thanks to coronary interventions. The aim of the study was to evaluate the outcomes of angioplasty and stenting in patients with cardiogenic shock caused by left main coronary artery (LMCA) disease.
  
  
  METHODS
  A group of 71 consecutive patients managed for LMCA disease in an emergency setting (38 patients in cardiogenic shock and 33 without shock symptoms) were followed up clinically and angiographically for one year. Periprocedural and late mortality was assessed as well as the incidence of restenosis and coronary re-interventions.
  
  
  RESULTS
  There were 17 deaths in the study population (23.9%). One-year survival in the subgroup with cardiogenic shock was 57.9% (22 patients) with 15 periprocedural deaths and 1 death 3 months after the procedure. Restenosis and associated target lesion revascularization were documented in 5 patients (29.4%) with and 4 patients (16.0%) without cardiogenic shock. Multivariate analysis revealed the following independent predictors of cardiogenic shock in patients undergoing emergency LMCA angioplasty: STEMI as the reason for intervention (OR 14.1; 95% CI 3.71-53.7; p < 0.0002) and a small minimal lumen diameter before the procedure (OR 0.43; 95% CI 0.2-0.93; p < 0.04). The only independent predictor of the death in patients with cardiogenic shock was a small minimal lumen diameter after the procedure (OR 0.31; 95% CI 0.1-0.99, p < 0.05).
  
  
  CONCLUSIONS
  High mortality was observed in the study population, especially in the subgroup with cardiogenic shock. Most deaths were periprocedural. Because of the high rate of restenosis, periodical angiographic follow-up is necessary, preferably twice in the first 6 months after stent implantation. (Cardiol J 2007; 14: 67-75).
authors.forename: Joanna
authors.initials: J
authors.lastname: Wiśniewska-Szmyt
authors.forename: Jacek
authors.initials: J
authors.lastname: Kubica
authors.forename: Adam
authors.initials: A
authors.lastname: Sukiennik
authors.forename: Marek
authors.initials: M
authors.lastname: Radomski
authors.forename: Marcin
authors.initials: M
authors.lastname: Rychter
authors.forename: Mirosław
authors.initials: M
authors.lastname: Jabłoński
authors.forename: Tomasz
authors.initials: T
authors.lastname: Białoszyński
authors.forename: Marek
authors.initials: M
authors.lastname: Koziński
authors.forename: Zofia
authors.initials: Z
authors.lastname: Grabczewska
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Grześk