Procedural Outcomes of Patients Undergoing Percutaneous Coronary Intervention for De Novo Lesions in the Ostial and Proximal Left Circumflex Coronary Artery
Section snippets
Methods
All patients with ostial/very proximal coronary artery lesions treated with PCI at MedStar Washington Hospital Center (Washington, DC) from 2003 to 2018 were included in this analysis. In the current analysis, the definition of an ostial lesion was extended to include the segment immediately beyond the ostium. Patients with PCI of at least 1 ostial lesion and with at least 1 year of available follow-up were included in the analysis. Patients who underwent stenting for distal LMCA lesions in
Results
A total of 4,759 patients with available 1-year follow-up had PCI for ostial/proximal lesions and were included in this analysis: 2,236 LAD, 980 LC, and 1,543 right. The age of this cohort was 66 ± 26 years, and 64.8% were men. A history of hypertension, DM, hypercholesterolemia, MI, PCI, coronary artery bypass surgery, peripheral arterial disease, congestive heart failure, or CRI was more common in the LC group. The clinical presentation for the LC group was mainly stable or unstable angina,
Discussion
The main findings from our study are as follows: (1) Patients who underwent PCI for an ostial or very proximal LC lesion had a higher prevalence of comorbid conditions, including a history of previous MI and coronary interventions, DM, and chronic kidney disease. (2) At 1-year follow-up, TLR-MACE was higher in the LC (16.7%) than in the right and LAD (11.8% and 12.5%, respectively, p <0.001), driven mainly by higher mortality rates in the LC group. (3) Among tested covariates, dialysis had the
Author Contribution
Anees Musallam: Conceptualization, Formal analysis, Writing original draft, Writing (review and editing).
Chava Chezar-Azerrad: Conceptualization, Methodology, Validation, Formal analysis, Writing (review and editing).
Rebecca Torguson: Conceptualization, Methodology, Validation, Formal analysis, Writing (review and editing).
Brian C. Case: Conceptualization, Formal analysis, Writing (review and editing).
Charan Yerasi: Conceptualization, Formal analysis, Writing (review and editing).
Brian J.
Disclosures
Toby Rogers—Consultant and proctor: Medtronic, Edwards Lifesciences; Advisory board: Medtronic. Equity interest: Transmural Systems. Ron Waksman—Advisory Board: Amgen, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.; Consultant: Amgen, Biotronik, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.; Grant support: AstraZeneca, Biotronik, Boston Scientific, Chiesi; Speakers Bureau: AstraZeneca, Chiesi;
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Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.