VolumeVol. 58 • Number No. 4 • October-December 2020 Back
Clinical Profile and Major Adverse Cardiovascular Outcomes in Patients who Underwent Coronary Revascularization for Left Main Coronary Artery Disease and Left Main Equivalent Coronary Artery Disease in a Tertiary Hospital
Authors: Jezreel L. Taquiso, Jaime Alfonso M. Aherrera, Enrique M. Chua III, Richard Henry P. Tiongco II
DOI: 10.65564/pjim.b9f1361125
Date of Publication: December 2020
Abstract
BACKGROUND: Percutaneous coronary intervention (PCI) for left main (LMCA) coronary artery disease (CAD) was found to be non-inferior and had similar major adverse cardiovascular events (MACE) to coronary artery bypass grafting (CABG). In the local setting, the clinical profile and MACE of patients who underwent either revascularization are, however, unknown.
OBJECTIVES: To determine the clinical profile and in-hospital MACE of patients who underwent revascularization (PCI or CABG) for LMCA and left main equivalent CAD.
METHODS: This is a prospective descriptive study. Clinical profile and in-hospital, 30-days and 90-days post revascularization MACE were determined.
RESULTS: Thirty-seven (37) adults were included. Most were males, diabetics, dyslipidemics, smokers, with previous cardiovascular events and premature CAD. Hypertension was significantly prevalent in the CABG group (PCI=62.50% vs CABG=90.48%, p=0.04). Patients who underwent CABG mostly presented with stable angina (p=0.0453). The majority of the PCI (68.75%) was done as an emergent/urgent procedure, with clear indications for PCI (i.e. STEMI). In-hospital all-cause mortality was significantly higher in the PCI group (PCI=50% vs CABG=0%, p<<0.05).
CONCLUSION: Patients with LMCA and left main equivalent CAD were mostly males and had traditional CAD risk factors. In-hospital mortality was significantly higher among the PCI group; however, those who underwent PCI were unstable and unlikely to be good surgical candidates for CABG.
Keywords: coronary artery disease; left main coronary artery disease; percutaneous coronary intervention; coronary artery bypass grafting; major adverse cardiovascular outcome
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