Clinical outcomes after unprotected left main coronary artery occlusion: A retrospective multicentre cohort analysis.
Details
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_E91A75B32573
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical outcomes after unprotected left main coronary artery occlusion: A retrospective multicentre cohort analysis.
Journal
Catheterization and cardiovascular interventions
ISSN
1522-726X (Electronic)
ISSN-L
1522-1946
Publication state
Published
Issued date
03/2023
Peer-reviewed
Oui
Volume
101
Number
4
Pages
679-686
Language
english
Notes
Publication types: Observational Study ; Multicenter Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Unprotected left main coronary artery (ULMCA) occlusion is a rare and disastrous condition with scarce data on presentation and outcomes. Herein, we report data on patients presenting with acute coronary syndrome due to ULMCA occlusion at four different institutions.
This is an international multicentre observational study. Baseline characteristics were retro- and prospectively collected. Clinical follow-up was prospective. The primary outcome was in-hospital death. Patients surviving the index hospitalization were compared with nonsurvivors to find predictors of survival.
The study population consisted of 55 patients. Eight patients (15%) died in the cath lab, and 23 (42%) died in hospital. Three (6%) deaths were noncardiac and due to major bleeding. Thirty-two (58%) patients survived the index hospitalization and were discharged. These patients were followed for a median of 17.5 months during which three cardiac deaths occurred. Repeat revascularization was performed in 25% (n = 8). Overall mortality at maximum follow-up was 47% (n = 26). The only significant predictor for hospital survival was left ventricular ejection fraction (odds ratio [OR]: 1.10 (per 1 point increase); 95% confidence interval [CI]: 1.02-1.19; p = 0.02).
ULMCA occlusion carries a high short-term mortality. Patients who survive index hospitalization have similar mortality rates as compared with other st elevation myocardial infarction patients.
This is an international multicentre observational study. Baseline characteristics were retro- and prospectively collected. Clinical follow-up was prospective. The primary outcome was in-hospital death. Patients surviving the index hospitalization were compared with nonsurvivors to find predictors of survival.
The study population consisted of 55 patients. Eight patients (15%) died in the cath lab, and 23 (42%) died in hospital. Three (6%) deaths were noncardiac and due to major bleeding. Thirty-two (58%) patients survived the index hospitalization and were discharged. These patients were followed for a median of 17.5 months during which three cardiac deaths occurred. Repeat revascularization was performed in 25% (n = 8). Overall mortality at maximum follow-up was 47% (n = 26). The only significant predictor for hospital survival was left ventricular ejection fraction (odds ratio [OR]: 1.10 (per 1 point increase); 95% confidence interval [CI]: 1.02-1.19; p = 0.02).
ULMCA occlusion carries a high short-term mortality. Patients who survive index hospitalization have similar mortality rates as compared with other st elevation myocardial infarction patients.
Keywords
Humans, Myocardial Infarction, Coronary Vessels, Hospital Mortality, Prospective Studies, Stroke Volume, Treatment Outcome, Ventricular Function, Left, Coronary Occlusion, Cohort Studies, Percutaneous Coronary Intervention, Coronary Artery Disease, acute myocardial infarction, cardiogenic shock, left main coronary artery occlusion, percutaneous coronary intervention
Pubmed
Web of science
Open Access
Yes
Create date
03/03/2023 17:53
Last modification date
16/11/2023 8:23