title: Current management of unprotected left main coronary artery disease: run-in survey of the RITMO (Registro Italiano sul Trattamento del tronco coMune non protettO) study.
abstract: The optimal approach for a significant unprotected left main coronary stenosis (ULM) is debated, in light of the recent progresses of percutaneous coronary intervention (PCI). However, coronary artery bypass grafting (CABG) is still considered the first choice treatment. Randomized trials comparing PCI and CABG are ongoing, yet patient selection will considerably limit their clinical applicability. We thus designed a prospective multicenter registry which will include patients with ULM disease independently from the subsequent medical, interventional or surgical treatment: the RITMO Study (Registro Italiano sul Trattamento del tronco coMune non protettO). During the RITMO run-in phase, we conducted a systematic survey of Italian catheterization laboratories to define current management strategies for ULM. A total of 240 Italian catheterization laboratory were sent an email questionnaire on current practices for ULM, with 45 (19%) detailed replies, for a total of 61,370 annual coronary angiographies. Data provided from responders showed a 5% (95% interval: 2-16) prevalence of ULM, with 50% (9-99) of ULM treated surgically and 10% (0-81) treated percutaneously. In conclusion, treatment of ULM in Italy remains prevalently surgical, even if PCI is performed in a sizable portion of patients with ULM.
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Dario
authors.initials: D
authors.lastname: Sillano
authors.forename: Giuseppe G L
authors.initials: GG
authors.lastname: Biondi-Zoccai
authors.forename: Stefano
authors.initials: S
authors.lastname: De Servi
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Trevi
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology; D003625:Data Collection / Q000379:methods; D019468:Disease Management; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries