Safety and Feasibility of Coronary Stenting in Unprotected Left Main Coronary Artery Disease in the Real World Clinical Practice—A Single Center ExperienceReport as inadecuate




Safety and Feasibility of Coronary Stenting in Unprotected Left Main Coronary Artery Disease in the Real World Clinical Practice—A Single Center Experience - Download this document for free, or read online. Document in PDF available to download.

Background

This study evaluated the feasibility, safety, and prognostic outcome in patients with significant unprotected left main coronary artery ULMCA disease undergoing stenting.

Method and Results

Between January 2010 and December 2012, totally 309 patients, including those with stable angina 13.9% 43-309, unstable angina 59.2% 183-309, acute non-ST-segment elevation myocardial infarction NSTEMI 24.3% 75-309, and post-STEMI angina i.e., onset of STEMI<7 days 2.6% 8-309 with significant ULMCA disease >50% undergoing stenting using transradial arterial approach, were consecutively enrolled. The patients’ mean age was 68.9±10.8 yrs. Incidences of advance congestive heart failure CHF defined as ≥ NYHA Fc 3 and multi-vessel disease were 16.5% 51-309 and 80.6% 249-309, respectively. Mechanical supports, including IABP for critical patients defined as LVEF <35%, advanced CHF, or hemodynamically unstable and extra-corporeal membrane oxygenator ECMO for hemodynamically collapsed patients, were utilized in 17.2% 53-309 and 2.6% 8-409 patients, respectively. Stent implantation was successfully performed in all patients. Thirty-day mortality rate was 4.5% 14-309 cardiac death: 2.9% 9-309 vs. non-cardiac death: 1.6% 5-309 without significant difference among four groups 2.3% 1 vs. 2.7% 5 vs. 9.3% 7 vs. 12.5% 1, p = 0.071. Multivariate analysis identified acute kidney injury AKI as the strongest independent predictor of 30-day mortality p<0.0001, while body mass index BMI and white blood cell WBC count were independently predictive of 30-day mortality p = 0.003 and 0.012, respectively.

Conclusion

Catheter-based LM stenting demonstrated high rates of procedural success and excellent 30-day clinical outcomes. AKI, BMI, and WBC count were significantly and independently predictive of 30-day mortality.



Author: Wei-Chieh Lee , Tzu-Hsien Tsai , Yung-Lung Chen, Cheng-Hsu Yang, Shyh-Ming Chen, Chien-Jen Chen, Cheng-Jei Lin, Cheng-I Cheng, Ch

Source: http://plos.srce.hr/



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