ArticleCureus2025
Outcome of Percutaneous Coronary Intervention for Left Versus Non-left Main Coronary Artery in Acute Coronary Syndrome: A Comparative Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
BACKGROUND AND
objectiveAcute coronary syndromes (ACS), particularly those affecting the left main coronary artery (LMCA), are associated with high morbidity and mortality. The objective of the present study was to investigate long-term outcomes in patients who underwent percutaneous coronary intervention (PCI) for ACS affecting the LMCA compared to those with non-LMCA involvement.
methodsThis interventional study was conducted at the Department of Cardiology of MH Shamorita Medical College Hospital in Dhaka, Bangladesh, from January 2023 to June 2024. A total of 101 patients with ACS who underwent PCI participated in the study. Of whom, 51 were in the LMCA group and 50 were in the non-LMCA group. Follow-up assessment was done at the third, sixth, and 12th months, focusing on major adverse cardiovascular events (MACE) as the primary endpoint and persistent symptoms, repeat revascularization, and stent thrombosis as secondary endpoints.
resultsThe mean age of the LMCA and non-LMCA groups was 56 and 54 years, respectively, with a higher female proportion in the LMCA group. The patients in the LMCA group presented with more complex lesions, with a mean synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) score of 23.6. The MACE rate was notably higher in the LMCA group at 6%, compared to 2% in the non-LMCA group (p=0.013). Myocardial infarction (MI) occurred in 4% of the LMCA group, with no events in the non-LMCA group. Persistent symptoms and repeat revascularization were also more prevalent in the LMCA group (6% and 4%, respectively, p-value <0.05).
conclusionsPatients with ACS involving the LMCA experienced higher rates of adverse outcomes, particularly MI and repeat revascularization, following PCI compared to non-LMCA cases.
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