Left Main Coronary Artery Disease: Secular Trends in Patient Characteristics, Treatments, and Outcomes

Left main coronary artery (LMCA) disease is the highest-risk lesion subset of ischemic heart disease, and has traditionally been an indication for coronary artery bypass grafting (CABG). Recent evidence suggests comparable clinical outcomes between percutaneous coronary intervention (PCI) and CABG f...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2016-09, Vol.68 (11), p.1233-1246
Main Authors: Lee, Pil Hyung, Ahn, Jung-Min, Chang, Mineok, Baek, Seunghee, Yoon, Sung-Han, Kang, Soo-Jin, Lee, Seung-Whan, Kim, Young-Hak, Lee, Cheol Whan, Park, Seong-Wook, Park, Duk-Woo, Park, Seung-Jung
Format: Article
Language:English
Subjects:
Angioplasty
Cardiology
Cardiovascular disease
Clinical outcomes
Clinical trials
Coronary Artery Bypass
Coronary Artery Disease - drug therapy
Coronary Artery Disease - surgery
Coronary vessels
Heart attacks
Humans
Mortality
Patients
Percutaneous Coronary Intervention
Practice Guidelines as Topic
Stents
Surgery
Thrombosis
Treatment Outcome
Trends
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Left main coronary artery (LMCA) disease is the highest-risk lesion subset of ischemic heart disease, and has traditionally been an indication for coronary artery bypass grafting (CABG). Recent evidence suggests comparable clinical outcomes between percutaneous coronary intervention (PCI) and CABG for LMCA disease, with similar rates of mortality and serious composite outcomes, a higher rate of stroke with CABG, and a higher rate of repeat revascularization with PCI. These results have been translated to the current guideline recommendation that PCI is a reasonable alternative to CABG in patients with low to intermediate anatomic complexity. However, how the characteristics, treatment, and clinical outcomes of patients with unprotected LMCA disease have evolved over time has not yet been fully evaluated. We therefore described secular trends in the characteristics and long-term outcomes of unprotected LMCA disease using "real-world" clinical experience from the IRIS-MAIN (Interventional Research Incorporation Society-Left MAIN Revascularization) registry together with a broad review of this topic.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2016.05.089