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Early and late clinical outcomes after primary stenting of the unprotected left main coronary artery stenosis in the setting of acute myocardial infarction.

Abstract：

BACKGROUND:Acute left main coronary artery occlusion is a dramatic condition with very high mortality. The study was aimed to evaluate the effect of primary stenting in patients with left main coronary artery (LMCA) disease in the setting of acute myocardial infarction (AMI). METHODS:Between June 1997 and April 2002, primary stenting for left main coronary artery disease was performed in 18 patients with acute myocardial infarction. We evaluated early and late clinical outcomes, and prognostic determinants in this clinical setting. RESULTS:Mean ages of patients were 59 +/- 12 years. Fourteen patients had cardiogenic shock on admission. Angiographic success (TIMI flow > or = 2 and diameter stenosis < 30% after stenting) was achieved in 17 patients (94%). In-hospital death occurred in eight patients (44%). Two patients (11%) received emergent bypass surgery because of hemodynamic instability after primary stenting. On univariate analysis, good pre-intervention TIMI flow (grade > or = 2) was identified as a good prognostic determinant of in-hospital survival. During mean follow-up of 39 +/- 22 months, there was no late death and one patient received bypass surgery. Probability of freedom from death at 3-year was 56 +/- 12%. CONCLUSION:Primary stenting is a valuable therapeutic strategy for left main coronary disease in the setting of acute myocardial infarction, and it might save the life especially in patients with good pre-intervention TIMI flow (grade > or = 2). Long-term clinical outcome of patients surviving to hospital discharge is favorable.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Lee SW,Hong MK,Lee CW,Kim YH,Park JH,Lee JH,Han KH,Kim JJ,Park SW,Park SJ

doi

10.1016/j.ijcard.2003.07.034

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

73-6

issue

1

eissn

0167-5273

issn

1874-1754

pii

S0167527303005801

journal_volume

97

pub_type

杂志文章

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