J Transcat Intervent.2019;27:eA201825.
Percutaneous intervention in unprotected left main coronary artery lesions
The opportunity for percutaneous treatment of coronary artery disease in unprotected left main artery has increased. This treatment possibility is based on favorable results in the literature. The objective of this study was to compare the demographic profile and results of percutaneous coronary intervention in patients with unprotected left main coronary artery lesions.
The period from 2006 to 2016 was analyzed, divided into three intervals – 2006 to 2008, 2009 to 2011 and 2012 to 2016, based on the database of the Central Nacional de Intervenções Cardiovasculares (CENIC). We verified, in the sample, the influence of variables of interest in relation to mortality.
A total of 767 patients were included. Clinical, angiographic and procedural characteristics changed throughout the decade analyzed, mostly regarding greater use of drug-eluting stents. There was no difference in mortality or major adverse cardiovascular events. Acute clinical presentation, left ventricular dysfunction, hemodynamic instability or multivessel coronary artery disease were predictors of mortality by logistic regression analysis.
The use of drug-eluting stents to address the unprotected left main coronary artery has increased in contemporary practice. Although no differences were found in cardiac event rates among the periods, it was noted that emergency procedures in unstable patients, patients with left ventricular dysfunction or with multivessel coronary artery disease remained as important predictors of mortality in this challenging scenario.