Korean J Intern Med.  2016 Nov;31(6):1084-1092. 10.3904/kjim.2014.373.

Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease

• Hyun DY
• Jeong MH
• Sim DS
• Jeong YA
• Cho KH
• Kim MC
• Kim HK
• Jeong HC
• Park KH
• Hong YJ
• Kim JH
• Ahn Y
• Kang JC

• KMID: 2382858
• DOI: http://doi.org/10.3904/kjim.2014.373

Abstract

BACKGROUND/AIMS
This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease.
METHODS
From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years). We evaluated clinical and angiographic characteristics and major adverse cardiac events (MACE) during 2-year clinical follow-up.
RESULTS
Mean age of studied patients was 64 ± 10 years with 339 male patients. Average stent diameter was 3.6 ± 0.4 mm and stent length was 19.7 ± 6.3 mm. Stent implantation techniques and use of intravascular ultrasound guidance were not different between two groups. In-hospital mortality was 0% in group I and 7% in group II (p = 0.035). One-month mortality was 0% in group I and 7.7% in group II (p = 0.968). Two-year survival rate was 93% in the group I and 88.4% in the group II (p = 0.921). Predictive factors for 2-year MACE were hypertension, Killip class ≥ 3, and use of intra-aortic balloon pump by multivariate analysis.
CONCLUSIONS
Although in-hospital mortality rate was higher in ACS than in SAP, clinical outcomes during 2-year clinical follow-up were similar between SAP and ACS after PCI of ULMCA.

Keyword

Coronary artery disease; Left main stem; Percutaneous coronary intervention

MeSH Terms

Acute Coronary Syndrome*
Angina Pectoris
Angina, Stable*
Coronary Artery Disease*
Coronary Vessels*
Follow-Up Studies
Hospital Mortality
Humans
Hypertension
Male
Mortality
Multivariate Analysis
Percutaneous Coronary Intervention*
Stents
Survival Rate
Ultrasonography