Search

Background: Unprotected left main coronary artery disease was defined as having a left main coronary artery stenosis of greater than 50% and the absence of bypass grafts to the left anterior descending or left circumflex coronary arteries. Objective: The purpose of this study was to assess major adverse cardiovascular events (MACE) and its relationship to syntactic score in connection to short and intermediate term clinical outcomes of Percutaneous Coronary Intervention (PCI) in unprotected left main coronary artery (LMCA) illness. Patients and Methods: A total of 50 patients with unprotected left main coronary artery (ULMCA) disease were enrolled in a prospective study and received drug-eluting stent (DES) implantation at Cardiology Department, Mansoura University Hospital, and National Heart Institute, Egypt from June 2018 to December 2019. Result: ROC curve analysis showed that Syntax score was the best method as a marker for prediction of MACE; it had sensitivity of 73.3%, specificity of 77.1% at AUC of 0.770 with cut off value >32.5. On univariate analysis, age, STelevation myocardial infarction (STEMI), osteal, mild, distal, as well as all LM length disease were risk factors of MACE (P <0.05). However, on multivariate analysis, osteal, all LM disease, STEMI, and high SYNTAX score were significant predictors of MACE (P <0.05). Conclusion: ULMCA stenosis can be successfully treated by stenting. Stenting of distal LM lesions with low or intermediate SYNTAX scores by site evaluation, PCI with drug-eluting stents, and short- and intermediate-term followup, results in a lower incidence of mortality, stroke, or myocardial infarction. [ABSTRACT FROM AUTHOR]

Background: The primary reference criterion for evaluating coronary artery stenosis functional significance is fractional flow reserve (FFR). It helps the interventionist to define appropriate angiographic borderline coronary lesions that should or should not be treated with a stent. Objective: To evaluate the experience of the cardiology department, MUST University, on the use of FFR and its impact on patients with a borderline coronary lesion as regard revascularization decision-making. Patients and methods: A retrospective study were done on 86 patients with borderline lesions undergoing coronary angiograms for whom FFR was performed. Three experienced cardiac interventionists re-analyzed their coronary angiography and whether to delay or conduct revascularization with borderline stenotic lesions (40-70 %). A distinction was made between the findings of quantitative coronary angiography (QCA), visual and functional assessment of coronary stenosis severity. Result: Eighty-six patients (51 males and 35 females) with a mean age of 58.60 ± 9.20 were enrolled in the current study. FFR was < 0.80 in 26.74% (23/86) of the patients, and they had coronary angioplasty. Between quantitative evaluation of lesion diameter by FFR and visual measurement, the correlation was -0.645 (P < 0.001). Seven patients (8.139%) had FFR > 0.8 left main (LM) lesion and for the other vessels with severe coronary lesions, stenting was performed. Conclusion: In patients having borderline coronary artery stenosis, FFR is an important tool for clinical decisions making about procedures of revascularization. FFR results in alteration in the coronary intervention judgment. [ABSTRACT FROM AUTHOR]