Effect of coronary dominance on 2‐year outcomes after percutaneous coronary intervention in patients with acute coronary syndrome

• Published in: Catheterization and cardiovascular interventions 2017-03, Vol.89 (S1), p.549-554
• Main Authors: He, Chen, Ma, Yuan‐Liang, Wang, Chuang‐Shi, Song, Ying, Tang, Xiao‐Fang, Zhao, Xue‐Yan, Gao, Run‐Lin, Yang, Yue‐Jin, Xu, Bo, Yuan, Jin‐Qing
• Format: Article
• Language: English
• Subjects: acute coronary syndrome; Acute Coronary Syndrome - complications; Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - therapy; Aged; Chi-Square Distribution; China; coronary anatomy; Coronary Angiography; Coronary Vessel Anomalies - complications; Coronary Vessel Anomalies - diagnostic imaging; Coronary Vessel Anomalies - mortality; Databases, Factual; Female; Humans; Kaplan-Meier Estimate; left dominance; Male; Middle Aged; Multivariate Analysis; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - mortality; Predictive Value of Tests; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Risk Factors; SYNTAX score; Time Factors; Treatment Outcome
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.26978

Objectives This retrospective, single‐center, observational analysis from prospectively collected database evaluated whether left dominance affected the long‐term outcomes of acute coronary syndrome patients undergoing percutaneous coronary intervention, and whether the effect was independent of SYNTAX score. Background Left dominance is believed to be associated with worse prognoses. The anatomical SYNTAX score is a scoring system based on the complexity and severity of coronary lesions and is thought to be a prognostic tool to predict short‐ and long‐term outcomes. There are few studies about whether the effect of left dominance is independent of SYNTAX score. Methods Between January 2013 and December 2013, 6255 consecutive acute coronary syndrome patients who were admitted to Fuwai hospital and underwent percutaneous coronary intervention (PCI) were enrolled in this study. Based on coronary dominance and the calculation methods of the SYNTAX score, patients were divided into a left‐dominant group (LD group; 390 patients) and a right‐dominant or co‐dominant group (RD + Co group, 5865 patients). Result The 2‐year mortality rate was significantly higher in the LD group than in the RD + Co group (2.58% vs. 1.23%, P = 0.024). In multivariate Cox analysis, the independent predictors of mortality were coronary dominance, IABP support, age, baseline SYNTAX score, and ejection fraction. Conclusions LD was an independent predictor of long‐term mortality in ACS patients undergoing PCI. The effect of LD still existed after adjustment for several important variables and was independent of SYNTAX score. © 2017 Wiley Periodicals, Inc.