While unprotected culprit left main coronary artery disease (LMCAD) acute coronary syndrome (ACS) necessitating percutaneous coronary intervention (PCI) is uncommon, it is associated with reduced survival after long-term follow-up. This according to a study that included 8,794 patients hospitalized with unstable angina/non-ST elevation myocardial infarction (UA/NSTEMI) or ST-elevation myocardial infarction (STEMI) treated with PCI. Of this group, 83 (0.94%) patients were identified as having culprit LMCAD ACS. Researchers found:
- 40 patients presented with STEMI and 43 patients presented with UA/STEMI.
- LM STEMI patients were younger and had less hypertension compared to LM UA/NSTEMI, with a trend towards greater frequency of cardiogenic shock.
- In-hospital mortality was 33% in LM STEMI vs 9% in LM UA/STEMI.
- Over a median follow-up of 6.3 years, long-term survival rates in both groups were similar.
Gharacholou SM, Ijioma NN, Lennon RJ, et al. Characteristics and long term outcomes of patients with acute coronary syndromes due to culprit left main coronary artery disease treated with percutaneous coronary intervention. [Published online ahead of print February 22, 2018]. Am Heart J. doi:10.1016/j.ahj.2018.02.012.
This Week's Must Reads
LDL-C Assessment of Secondary Non-HDL-C & ApoB Targets, Circulation; ePub 2018 Mar 5; Sathiyakumar, et al
Attaining Lipid Targets in Patients with PAD, J Clin Lipidol; ePub 2018 Feb 27; Dopheide, et al
Lower Risk of VTE with Statins & LDL-C Reduction, Atherosclerosis; ePub 2018 Mar 1; Zaccardi, et al
Elevated Lp(a) Levels & Higher CAC Scores, J Clin Lipidol; ePub 2018 Feb 17; Verweij, et al
Does Elevated Lp(a) & FH Increase CAD Risk?, Clin Cardiol; ePub 2018 Feb 26; Ellis, Pang, et al
Must Reads in Acute Coronary Syndromes
Outcomes in Patients with ACS Due to LMCAD , Am Heart J; ePub 2018 Feb 22; Gharacholou, et al
Adherence Rates to Secondary Prevention Meds, Circulation; ePub 2018 Jan 31; Mathews, et al
Acute Myocardial Infarction After Influenza , N Engl J Med; 2018 Jan 25; Kwong, Schwartz, et al
Outcomes in Women & Minorities vs White Men After PCI, JAMA Cardiol; 2017 Dec; Batchelor, et al
High-Sensitivity Troponin T in Low-Risk Patients , JAMA Cardiol; ePub 2017 Dec 13; Peacock, et al