Clinical outcomes and predictors of unprotected left main stem culprit lesions in patients with acute ST segment elevation myocardial infarction

2013 ◽  
Vol 83 (7) ◽  
pp. E243-E250 ◽  
Author(s):  
Ju Yeol Baek ◽  
Suk Min Seo ◽  
Hun-Jun Park ◽  
Pum Joon Kim ◽  
Mahn Won Park ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Main Stem ◽  
Left Main ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Left Main Stem ◽  
St Segment

scholarly journals LEFT MAIN STEM DISEASE ON CORONARY ANGIOGRAPHY IN PATIENTS WITH NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

2021 ◽  
Vol 54 (1) ◽  
pp. 30-33
Author(s):  
Kashif Ali Hashmi ◽  
Momin Rasheed Khan ◽  
Atif Ali Hashmi ◽  
Fahar Adnan ◽  
Muhammad Irfan
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Main Stem ◽  
Left Main ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Left Main Stem ◽  
St Segment ◽  
Left Main Stem Disease

Objectives: The purpose of our study was to determine the frequency of left main stem disease on coronary angiography in patients with non-ST segment elevation myocardial infarction (NSTEMI). By studying the exact frequency of the left main stem (LMS) disease in NSTEMI patients in our population, we will be able to better risk stratify and plan further management for this group of patients. Methodology: This cross-sectional study was conducted at the Department of Cardiology, Chaudhry Pervez Elahi Institute of Cardiology (CPEIC), Multan from 14-June-2017 to 13-Dec-2017. Total 248 patients with NSTEMI were included in the study. Coronary angiography was done in all selected patients. Diagnosis of LMS disease was made when stenosis in the LMS artery was more than half of the diameter of the left main coronary artery. Results: There were 80.6% male and 19.4% female patients with a mean age 49.39±7.23 years. In this study, 37.1% patients were found with left main stem disease. Among LMS disease patients, there was 82.6% male and 17.4% female patients. 55.4% of patients were aged 50 years and above. 40.2% were smokers and 33.7% were diabetic. No significant association of LMS was found with the age group (p=0.66), gender (p=0.54), smoking status (p=0.54) and diabetes mellitus (p=0.95). Conclusion: In this study, we found a high frequency of LMS disease in our population. This subset of patients with NSTEMI requires early re-vascularization. This also signifies a need to re-evaluate our screening programs and management protocols related to coronary artery disease.

scholarly journals TCT-97 Clinical Outcomes of Unprotected Left Main ST-Segment Elevation Myocardial Infarction

2021 ◽  
Vol 78 (19) ◽  
pp. B40-B41
Author(s):  
Aaqib Malik ◽  
Tomo Ando ◽  
Alexandros Briasoulis ◽  
Jayakumar Sreenivasan ◽  
Hisato Takagi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Left Main ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Patient survival after acute myocardial infarction treated with primary percutaneous coronary intervention within the left main coronary artery according to time of admission

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Januszek ◽  
K Bujak ◽  
M Gasior ◽  
D Dudek ◽  
S Bartus
Keyword(s):  
Myocardial Infarction ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Night Time ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Coronary Syndromes ◽  
Overall Mortality

Abstract Background Previously published studies assessing the time effect of primary percutaneous intervention (PCI) on long-term clinical outcomes in an overall group of patients with acute coronary syndromes has been widely investigated. It has been suggested that night-time admission may negatively influence long-term overall mortality. Patients treated within the left main coronary artery (LMCA) belong a narrow group of high-risk procedures that require an operator and a team with high skills. Purpose The aim of the presented study was to assess the relationship between the time of pPCI (day- vs. night-time) and overall mortality among patients treated due to AMI within the LMCA. Methods This observational study was performed on 443,805 patients hospitalised due to non-ST segment elevation myocardial infarction (NSTEMI) or ST-segment elevation myocardial infarction (STEMI). Patients were prospectively enrolled between January 2006 and December 2018 in the ongoing Polish Registry of Acute Coronary Syndromes (PL-ACS). From the overall group of patients, the authors selected 5,404 patients treated within the LMCA. After taking exclusion criteria into consideration, the patients were divided according to time of PCI treatment: daytime hours (7:00 a.m.-10:59 p.m.) – 2,809 patients and night-time hours (11:00 p.m. - 6.59 a.m.) – 473 patients. Results Patients treated during night-time and daytime did not differ significantly in age (70.79 [61.52–79.73] vs. 69.73 [60.8–78.82] years, p=0.13) or gender – males (67.6% vs. 67.0%, p=0.79). Patients treated during daytime presented with significantly higher rate of STEMIs (67.2% vs. 49.9%) and lower rate of NSTEMIs (32.8% vs. 50.1%) in comparison to those treated during night-time (p<0.001). The 30-day and 12-month overall mortality rates were significantly greater among patients treated during night-time hours (20.3% vs. 14.9%, p=0.003) and (31.7% vs. 26.2%, p=0.001). Kaplan-Maier survival curves confirmed this relationship (p=0.001). Multiple regression analysis did not confirm that the time of pPCI (day- vs. night-time) is significantly related to survival (hazard ratio [HR]: 1.22; 95% confidence interval [CI]: 0.96–1.55, p=0.099). However, significance was achieved for the left ventricle ejection fraction (HR: 0.95; 95% CI: 0.94–0.95, p<0.001), systolic blood pressure on admission (HR: 0.995; 95% CI: 0.991–0.998, p=0.005), age (HR: 1.04; 95% CI: 1.03–1.05, p<0.001), the use of intra-aortic balloon counterpulsation (HR: 1.04; 95% CI: 1.03–1.05, p<0.001) and diagnosed peripheral artery disease (HR: 1.55; 95% CI: 1.2–2.01, p<0.001). Conclusions The time of pPCI (day- vs. night-time) in patients with AMI and treated within the LMCA is related to the overall 30-day and 12-month survival which is poorer in those treated during the night-time. However, this relationship was not confirmed by multiple regression analysis and was not found to be significant among other stronger predictors. Funding Acknowledgement Type of funding source: None

scholarly journals Rapid progression of left main disease in a patient with anterior ST-segment elevation myocardial infarction

2018 ◽  
Vol 13 (1-2) ◽  
pp. 24-24
Author(s):  
Boris Starčević ◽  
Mario Sičaja ◽  
Ognjen Čančarević ◽  
Jasmina Ćatić ◽  
Mario Udovičić ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Rapid Progression ◽  
Left Main ◽  
Left Main Disease ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment
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