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Left main PCI: An observational analysis from large single-centre experience

BACKGROUND: Although trials have shown efficacy of unprotected left main percutaneous coronary intervention (uLMPCI), data from Indian subcontinent are lacking. Hence, we planned this observational analysis of single-center uLMPCI data. OBJECTIVES: To study long-term outcome after uLMPCI and identif...

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Autores principales: Goel, Pravin K., Jatain, Suman, Khanna, Roopali, Pandey, C.M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759493/
https://www.ncbi.nlm.nih.gov/pubmed/26896264
http://dx.doi.org/10.1016/j.ihj.2015.07.010
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author Goel, Pravin K.
Jatain, Suman
Khanna, Roopali
Pandey, C.M.
author_facet Goel, Pravin K.
Jatain, Suman
Khanna, Roopali
Pandey, C.M.
author_sort Goel, Pravin K.
collection PubMed
description BACKGROUND: Although trials have shown efficacy of unprotected left main percutaneous coronary intervention (uLMPCI), data from Indian subcontinent are lacking. Hence, we planned this observational analysis of single-center uLMPCI data. OBJECTIVES: To study long-term outcome after uLMPCI and identify predictors of adverse outcome. METHODS: Case details of 62 consecutive patients of uLMPCI between 2006 and 2013 were retrieved from a computerized database wherein detailed records were maintained. RESULTS: Mean follow-up duration was 669.8 ± 404.2 days. Procedural success rate was 98.4%. Primary endpoint was composite of major adverse cardiovascular and cerebrovascular events (MACCE), which included cardiac death (CD), cerebrovascular accident (CVA), myocardial infarction (MI), and need for repeat intervention (RI) at three years. MACCE occurred in 13 (20.9%) patients. Cardiac death (CD), (including possible stent thrombosis), RI, and CVA occurred in 6 (9.7%), 5 (8%), and 2 (3.2%) patients, respectively. Overall three-year MACCE-free survival rate was 76.7%. Event-free survival rate was similar among patients who underwent uLMPCI alone and patients who underwent uLMPCI along with additional one-vessel PCI [(88.9% vs 81.8%), p = 0.492], while survival rate was lower in patients who underwent uLMPCI along with PCI of additional two or more vessels (40%, p = 0.036). Patients with syntax score ≤32 had higher event-free survival rate than those with syntax score >32 [(87.1% vs 33.3%), p = 0.001]. Syntax score >32 was the only independent predictor of adverse outcome. CONCLUSION: uLMPCI is safe and effective alternative to CABG for LM alone and LM plus single-vessel disease with syntax score ≤32.
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spelling pubmed-47594932017-01-01 Left main PCI: An observational analysis from large single-centre experience Goel, Pravin K. Jatain, Suman Khanna, Roopali Pandey, C.M. Indian Heart J Original Article BACKGROUND: Although trials have shown efficacy of unprotected left main percutaneous coronary intervention (uLMPCI), data from Indian subcontinent are lacking. Hence, we planned this observational analysis of single-center uLMPCI data. OBJECTIVES: To study long-term outcome after uLMPCI and identify predictors of adverse outcome. METHODS: Case details of 62 consecutive patients of uLMPCI between 2006 and 2013 were retrieved from a computerized database wherein detailed records were maintained. RESULTS: Mean follow-up duration was 669.8 ± 404.2 days. Procedural success rate was 98.4%. Primary endpoint was composite of major adverse cardiovascular and cerebrovascular events (MACCE), which included cardiac death (CD), cerebrovascular accident (CVA), myocardial infarction (MI), and need for repeat intervention (RI) at three years. MACCE occurred in 13 (20.9%) patients. Cardiac death (CD), (including possible stent thrombosis), RI, and CVA occurred in 6 (9.7%), 5 (8%), and 2 (3.2%) patients, respectively. Overall three-year MACCE-free survival rate was 76.7%. Event-free survival rate was similar among patients who underwent uLMPCI alone and patients who underwent uLMPCI along with additional one-vessel PCI [(88.9% vs 81.8%), p = 0.492], while survival rate was lower in patients who underwent uLMPCI along with PCI of additional two or more vessels (40%, p = 0.036). Patients with syntax score ≤32 had higher event-free survival rate than those with syntax score >32 [(87.1% vs 33.3%), p = 0.001]. Syntax score >32 was the only independent predictor of adverse outcome. CONCLUSION: uLMPCI is safe and effective alternative to CABG for LM alone and LM plus single-vessel disease with syntax score ≤32. Elsevier 2016 2015-08-29 /pmc/articles/PMC4759493/ /pubmed/26896264 http://dx.doi.org/10.1016/j.ihj.2015.07.010 Text en © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Goel, Pravin K.
Jatain, Suman
Khanna, Roopali
Pandey, C.M.
Left main PCI: An observational analysis from large single-centre experience
title Left main PCI: An observational analysis from large single-centre experience
title_full Left main PCI: An observational analysis from large single-centre experience
title_fullStr Left main PCI: An observational analysis from large single-centre experience
title_full_unstemmed Left main PCI: An observational analysis from large single-centre experience
title_short Left main PCI: An observational analysis from large single-centre experience
title_sort left main pci: an observational analysis from large single-centre experience
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759493/
https://www.ncbi.nlm.nih.gov/pubmed/26896264
http://dx.doi.org/10.1016/j.ihj.2015.07.010
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