SHORT TERM AND LONG-TERM OUTCOMES OF LEFT MAIN PCI AT AFIC-NIHD
Keywords:Angioplasty, Left main, Primary angioplasty
Objective: To study the short-term and long-term outcomes of left main angioplasty at AFIC-NIHD.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD) in 2018.
Methodology: All cases of left main angioplasty done in 2018 were included in the study. The patients were followed up in clinic or on telephone and mortality (in-hospital, 30 days) outcomes and survival duration were recorded. Kaplan Meier curves were generated to show the survival difference between those who underwent primary or elective LMPCI and survival difference between patients based on extent of coronary artery disease.
Results: A total of 73 patients underwent elective or primary left main angioplasty. The extent of coronary artery disease was: single vessel coronary artery disease (26%), double vessel coronary artery disease (37%), and three vessel coronary artery disease (37%). Thirteen patients (17.8%) had primary left main angioplasty, and 60 patients (82.2%) had elective left main angioplasty. Intravascular ultrasound was performed in only 3 patients. The mean duration of follow up was 395 days. A total of 6 (8.2%) patients died. Three patients died in-hospital, another 2 within the first 30 days, and the remaining beyond 30 days. Two of the dead patients had double vessel coronary artery disease, and 4 had three vessel coronary artery disease. The survival difference between the primary vs elective groups was insignificant (Log Rank (Mantel-Cox) (p=0.27). The survival difference between the 3 groups with different extent of coronary artery disease was insignificant (p=0.15).
Conclusion: Left main PCI is a safe procedure with acceptable outcomes. Patients with more severe coronary artery disease tend to fare worse.