PhD Scientific Days 2023

Clinical Medicine I.

Five-year outcome of unprotected left main percutaneous coronary interventions: a single tertiary-care centre experience

Előadó neve

Dr. Nemeth, Orsolya

Neptun code

APRIO2

Előadó munkahelye

Gottsegen National Cardiovascular Center

Előadó telefonszáma

+36205452968

Előadó e-mail címe

n.orsi_97@hotmail.com

Az előadás címe

Five-year outcome of unprotected left main percutaneous coronary interventions: a single tertiary-care centre experience

Szerző(k) neve és munkahelye

Orsolya Nemeth1, Zsolt Piroth1
1 Gottsegen National Cardiovascular Center, Budapest

Bemutatás módja

Szóbeli

Szekció

Clinical Medicine I.

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction: Randomized studies on patients with unprotected left main coronary artery disease (ULMCA) involve highly selected populations therefore their conclusions have limited generalizability.
Aims: To investigate the 60-month mortality and event-free survival of consecutive patients undergoing ULMCA percutaneous coronary intervention (PCI) at our center. We aimed to determine the independent predictors of and the best risk score system to predict event-free survival.
Methods: All patients who underwent ULMCA PCI at our centre between 1 January 2010 and 30 June 2014 were included. No exclusion criterion was applied. Patients were divided in elective and acute groups. The endpoint of the study was the composite of all-cause mortality, myocardial infarction, and target lesion revascularization at 60 months.
Result: A total of 325 patients (mean age 68 ± 12 years, 65% male), 110 (34%) elective and 215 (66%) acute patients underwent ULMCA PCI during this period. The mean survival (50.1 vs. 41 months, p=0.006) and event-free survival (46.2 vs. 33 months, p=0.001) of elective patients were significantly higher than those of acute patients. There was no significant difference between the groups in terms of survival (52.2 vs. 51.2 months, p=0.497) or event-free survival (48.1 vs. 43.3 months, p=0.075) among those who survived the first 30 days without any event. Of the risk scores, the SYNTAX II score was the most predictive both in elective (AUC=0.759) and acute patients (AUC=0.790), whereas the SYNTAX score was the least predictive (elective AUC=0.571, acute AUC=0.641). Age (HR 1.038; 95% CI 1.005-1.072, p=0.022 and HR 1.029; CI 1.011-1.048, p=0.002) and left ventricular function (HR 2.460; CI 1.230-4.923, p=0.011 and HR 2,141; CI 1.341-3.418, p=0.001) were independent predictors of events both in elective and acute patients, respectively. Renal function (HR 3.015; CI 1.981-4.587, p<0.001), diabetes mellitus (HR 1.645; CI 1.105-2.450, p=0.014) and previous myocardial infarction (HR 1.849; CI 1.215-2.815, p=0.004) were independent predictors of event-free survival among acute patients only.
Conclusion: ULMCA PCI has favorable long-term outcome. In terms of mortality, the first 30 days are critical in acute patients, after that, survival and event-free survival are similar in acute and elective ULMCA patients undergoing PCI.
Funding: None.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Zsolt Piroth MD., PhD.

Publication of my abstract

I give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

7378

Start

09:45

End

10:00

Authors (legacy)

Orsolya Nemeth1, Zsolt Piroth1
1 Gottsegen National Cardiovascular Center, Budapest