scholarly journals Long-Term Outcome of Left Main Percutaneous Coronary Intervention in Patients with Coronary Artery Disease

2020 ◽  
pp. 13-18
Author(s):  
A. Marushko ◽  
G. Mankovsky ◽  
Ye. Marushko ◽  
S. Kuzmenko ◽  
N. Rudenko
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Group ◽  
Coronary Intervention ◽  
Long Term Results ◽  
Syntax Score ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Artery Disease

At the present time, left main (LM) stenting is an alternative to coronary artery bypass grafting in patients with coronary artery disease (CAD) and haemodynamically significant LM lesion. Despite of long history of LM interventions, long-term results are still poorly understood. Presented data are still conflicting and need further affirmation. Aim. To investigate long-term outcomes of percutaneous coronary intervention (PCI) in patients with LM lesions. Materials and methods. The study included 27 patients with CAD with haemodynamically significant LM lesion who underwent PCI. The risk was calculated using the SYNTAX Score and the SYNTAX Score II in all the patients. According to the results of the calculation, patients were divided into 3 groups: the low risk group (SYNTAX Score = 0-22) included 16 (59.3%) patients, the medium risk group (SYNTAX Score = 23-32) included 8 (29.6%) patients, and the high-risk group (SYNTAX Score > 32) included 3 (11.1%) patients. Results. The incidence of major adverse cardiovascular events during the mean follow-up period of 30.9 months was 11.1%, while 89.9% of patients had good immediate and long-term results of the procedure. Fatal cases were reported only in groups of patients with intermediate and high risk according to evaluation by the SYNTAX score. No fatal cases were observed in low risk group of patients according to the SYNTAX score. Thus, patient affiliation with one of the risk groups based on the SYNTAX Score scale affected the long-term LM PCI outcomes. Conclusions. In patients with LM lesion, PCI can be performed with good long-term results in 89.9% of cases. The main criterion for the selection of patients for LM PCI is the risk calculation data based on the SYNTAX Score scale, taking into account the decision of the Heart Team.

scholarly journals Identify Unsuitable Patients with Left Main Coronary Artery Disease in Intermediate SYNTAX Scores Treated by Percutaneous Coronary Intervention

2017 ◽  
Vol 20 (6) ◽  
pp. 258 ◽  
Author(s):  
Chunxiao Zhang ◽  
Yaguang Zheng ◽  
Xinbin Liu ◽  
Yutong Cheng ◽  
Yang Liu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Syntax Score ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
Repeated Revascularization

Background: With the follow-up extending to 5 years, the outcomes of SYNTAX (Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) trial were comparable between coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) in left-main (LM) patients with intermediate SYNTAX scores of 23–32. A subdivision depending on SYNTAX score will help to identify unsuitable LM patients with intermediate SYNTAX scores to receive PCI treatment.Methods: Between January 2011 and June 2013, 104 patients with LM Coronary Artery Disease (CAD) undergoing PCI were selected retrospectively. We compared clinical outcomes in patients with SYNTAX score <27 and ≥27. The follow-up time was 25.23 ± 7.92 months. Kaplan-Meier survival analyses and Cox proportional hazards models were used to compare various outcomes between two groups.Results: Higher rates of repeated revascularization (18.2% versus 4.2%, P = .027) and major adverse cerebro-cardiovascular events (MACCE) (24.2% versus 7.0%, P = .014) were shown in patients with SYNTAX score ≥ 27. After multivariate adjustment, a significant higher risk of repeated revascularization (hazard ratio: 6.25, 95% confidence interval: 1.48 to 26.37, P = .013) and MACCE (hazard ratio: 4.49, 95% confidence interval: 1.41 to 14.35, P = .011) were also found in patients with SYNTAX score ≥ 27.Conclusions: Based on the higher rate of repeated revascularization and MACCE, patients with LM CAD and intermediate SYNTAX scores will need a subdivision to identity the one not benefit from PCI. CABG is still the standard treatment method for patients of LM CAD with a SYNTAX score of ≥ 27.

Prognostic Impact of Red Cell Distribution Width on the Development of Contrast Induced Nephropathy, Major Adverse Cardiac Events, and Mortality in Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention.

2021 ◽  
Vol 17 ◽  
Author(s):  
Azka Latif ◽  
Muhammad Junaid Ahsan ◽  
Noman Lateef ◽  
Vikas Kapoor ◽  
Hafiz Muhammad Fazeel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Cardiac Events ◽  
Distribution Width ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Artery Disease

: Red cell distribution width (RDW) serves as an independent predictor towards the prognosis of coronary artery disease (CAD) in patients undergoing percutaneous coronary intervention (PCI). A systematic search of databases such as PubMed, Embase, Web of Science, and Cochrane library was performed on October 10th, 2019 to elaborate the relationship between RDW and in hospital and long term follow up all-cause and cardiovascular mortality, major adverse cardiac events (MACE) and development of contrast-induced nephropathy (CIN) in patients with CAD undergoing PCI. Twenty-one studies qualified this strict selection criteria (number of patients = 56,425): one study was prospective, and the rest were retrospective cohorts. Our analysis showed that patients undergoing PCI with high RDW had a significantly higher risk of in-hospital all-cause mortality (OR 2.41), long-term all-cause mortality (OR 2.44), cardiac mortality (OR 2.65), MACE (OR: 2.16) and odds of developing CIN (OR: 1.42) when compared to the patients with low RDW. Therefore, incorporating RDW in the predictive models for the development of CIN, MACE, and mortality can help in triage to improve the outcomes in coronary artery disease patients who undergo PCI.

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