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One-year outcomes of left main coronary artery stenting in patients with cardiogenic shock
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Abstract
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
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)
Keywords
left main coronary artery stenosis; percutaneous coronary intervention; cardiogenic shock
About this articleTitle
One-year outcomes of left main coronary artery stenting in patients with cardiogenic shock
Journal
Issue
Pages
67-75
Published online
2006-12-01
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443
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1187
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
