open access

Vol 14, No 1 (2007)
Original articles
Published online: 2006-12-01
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One-year outcomes of left main coronary artery stenting in patients with cardiogenic shock

Joanna Wiśniewska-Szmyt, Jacek Kubica, Adam Sukiennik, Marek Radomski, Marcin Rychter, Mirosław Jabłoński, Tomasz Białoszyński, Marek Koziński, Zofia Grąbczewska i Grzegorz Grześk
Cardiol J 2007;14(1):67-75.

open access

Vol 14, No 1 (2007)
Original articles
Published online: 2006-12-01

Abstract

Background: The high in-hospital mortality of patients with cardiogenic shock is being reduced thanks to coronary interventions. The aim of the study was to evaluate the outcomes of angioplasty and stenting in patients with cardiogenic shock caused by left main coronary artery (LMCA) disease.
Methods: A group of 71 consecutive patients managed for LMCA disease in an emergency setting (38 patients in cardiogenic shock and 33 without shock symptoms) were followed up clinically and angiographically for one year. Periprocedural and late mortality was assessed as well as the incidence of restenosis and coronary re-interventions.
Results: There were 17 deaths in the study population (23.9%). One-year survival in the subgroup with cardiogenic shock was 57.9% (22 patients) with 15 periprocedural deaths and 1 death 3 months after the procedure. Restenosis and associated target lesion revascularization were documented in 5 patients (29.4%) with and 4 patients (16.0%) without cardiogenic shock. Multivariate analysis revealed the following independent predictors of cardiogenic shock in patients undergoing emergency LMCA angioplasty: STEMI as the reason for intervention (OR 14.1; 95% CI 3.71–53.7; p < 0.0002) and a small minimal lumen diameter before the procedure (OR 0.43; 95% CI 0.2–0.93; p < 0.04). The only independent predictor of the death in patients with cardiogenic shock was a small minimal lumen diameter after the procedure (OR 0.31; 95% CI 0.1–0.99, p < 0.05).
Conclusions: High mortality was observed in the study population, especially in the subgroup with cardiogenic shock. Most deaths were periprocedural. Because of the high rate of restenosis, periodical angiographic follow-up is necessary, preferably twice in the first 6 months after stent implantation. (Cardiol J 2007; 14: 67–75)

Abstract

Background: The high in-hospital mortality of patients with cardiogenic shock is being reduced thanks to coronary interventions. The aim of the study was to evaluate the outcomes of angioplasty and stenting in patients with cardiogenic shock caused by left main coronary artery (LMCA) disease.
Methods: A group of 71 consecutive patients managed for LMCA disease in an emergency setting (38 patients in cardiogenic shock and 33 without shock symptoms) were followed up clinically and angiographically for one year. Periprocedural and late mortality was assessed as well as the incidence of restenosis and coronary re-interventions.
Results: There were 17 deaths in the study population (23.9%). One-year survival in the subgroup with cardiogenic shock was 57.9% (22 patients) with 15 periprocedural deaths and 1 death 3 months after the procedure. Restenosis and associated target lesion revascularization were documented in 5 patients (29.4%) with and 4 patients (16.0%) without cardiogenic shock. Multivariate analysis revealed the following independent predictors of cardiogenic shock in patients undergoing emergency LMCA angioplasty: STEMI as the reason for intervention (OR 14.1; 95% CI 3.71–53.7; p < 0.0002) and a small minimal lumen diameter before the procedure (OR 0.43; 95% CI 0.2–0.93; p < 0.04). The only independent predictor of the death in patients with cardiogenic shock was a small minimal lumen diameter after the procedure (OR 0.31; 95% CI 0.1–0.99, p < 0.05).
Conclusions: High mortality was observed in the study population, especially in the subgroup with cardiogenic shock. Most deaths were periprocedural. Because of the high rate of restenosis, periodical angiographic follow-up is necessary, preferably twice in the first 6 months after stent implantation. (Cardiol J 2007; 14: 67–75)
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Keywords

left main coronary artery stenosis; percutaneous coronary intervention; cardiogenic shock

About this article
Title

One-year outcomes of left main coronary artery stenting in patients with cardiogenic shock

Journal

Cardiology Journal

Issue

Vol 14, No 1 (2007)

Pages

67-75

Published online

2006-12-01

Bibliographic record

Cardiol J 2007;14(1):67-75.

Keywords

left main coronary artery stenosis
percutaneous coronary intervention
cardiogenic shock

Authors

Joanna Wiśniewska-Szmyt
Jacek Kubica
Adam Sukiennik
Marek Radomski
Marcin Rychter
Mirosław Jabłoński
Tomasz Białoszyński
Marek Koziński
Zofia Grąbczewska i Grzegorz Grześk

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