Abstract
Whether the lesion morphology and associated interventional procedures for the left main coronary artery disease (LMCA) could affect clinical outcome is still controversial. Therefore, we examined the impact of lesion morphology and associated procedures on clinical and angiographic outcomes of stenting for the LMCA. Among 7,660 patients with coronary intervention registered, we analyzed early angiographic results of 228 patients (179 men, mean age 69.4 years) concerned with LMCA lesions. In 121 out of 228 patients having long-term angiographic results, we examined the occurrence of major adverse coronary events (MACE) particularly in terms of the presence of acute coronary syndrome (ACS), the kind of stents, bear metal or drug eluting, the lesion morphology and associated procedures. Early angiographic success rate of LMCA stenting was 100 %, and clinical success rate was 94.3 %. During follow-up period for 3 years, MACE was observed in 17 patients. Under these conditions, multiple stenting (p < 0.01) and complicated procedures such as such as Y-stent, T-stent and crush stent (p < 0.01) were listed as risks for MACE, although there was no statistical difference in kinds of stent. Multivariate analysis demonstrated the significant disadvantage of complicated procedures using the bear metal stent on the occurrence of MACE (p < 0.01). These results demonstrate that the complicated procedures have great impact on clinical and angiographic outcomes after stenting for LMCA lesions, and suggest the simple procedure with a single stent for LMCA lesions in the present cohort. Whether the presence of ACS can affect the prognosis should further be sought.
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The authors had no conflicts of interest to declare in relation to this article.
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M. Kawashiri, K. Sakata and K. Uchiyama equally contributed to establishing the preset work in terms of interventional procedures, case enrollment and data analysis.
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List of affiliated hospitals
Kanazawa Cardiovascular Hospital, Fukui Cardiovascular Center, Maizuru Kyousai Hospital, Ishikawa Prefectural Central Hospital, Toyama Red Cross Hospital, Yokohama Sakae Kyousai Hospital, Takaoka City Hospital, Komatsu Municipal Hospital, Fukui Prefectural Hospital, Koseiren Takaoka Hospital, Kaga Municipal Hospital, Houju Memorial Hospital, Saiseikai Kanazawa Hospital, Kanazawa Social Insurance Hospital, KKR Hokuriku Hospital.
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Kawashiri, Ma., Sakata, K., Uchiyama, K. et al. Impact of lesion morphology and associated procedures for left main coronary stenting on angiographic outcome after intervention: sub-analysis of Heart Research Group of Kanazawa, HERZ, Study. Cardiovasc Interv and Ther 29, 117–122 (2014). https://doi.org/10.1007/s12928-013-0222-8
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DOI: https://doi.org/10.1007/s12928-013-0222-8