Clinical outcome of unprotected left main coronary artery disease in patients with acute myocardial infarction.
The clinical outcome of patients with acute myocardial infarction (MI) with unprotected left main coronary artery (LMCA) stenosis is not fully understood. We sought to assess the outcomes of patients with acute MI who underwent percutaneous coronary intervention (PCI) for unprotected LMCA stenosis. A total of 587 patients enrolled in the Korea Acute Myocardial Infarction Registry with LMCA stenosis were analyzed. Patients with culprit LMCA had higher inhospital mortality than patients with non-culprit LMCA (16.0% versus 8.9%, P = 0.008), but had similar clinical outcomes during a 12-month follow-up. Compared to CABG, PCI using drug-eluting stents (DES) was more frequently performed with similar early and 12-month clinical outcomes. The efficacy of sirolimus-eluting stents, paclitaxel-eluting stents, and zotarolimus-eluting stents were comparable at 12-month clinical follow-up. Predictors of 12-month mortality included mechanical ventilation, cardiogenic shock, age > 65 years, and ejection fraction < 40%. Patients with acute MI and culprit LMCA have higher early mortality than patients with non-culprit LMCA. PCI with DES is frequently performed and the clinical outcome is similar between the 3 types of first-generation DES.
Chonnam National University Hospital, Gwangju, Republic of Korea.
Doo Sun
DS
Sim
Youngkeun
Y
Ahn
Myung Ho
MH
Jeong
Young Jo
YJ
Kim
Shung Chull
SC
Chae
Taek Jong
TJ
Hong
In Whan
IW
Seong
Jei Keon
JK
Chae
Chong Jin
CJ
Kim
Myeong Chan
MC
Cho
Ki Bae
KB
Seung
D000368:Aged; D023921:Coronary Stenosis / Q000150:complications* / Q000401:mortality / Q000601:surgery; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011379:Prognosis; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends