Unprotected Left Main Revascularization in the Setting of Non-coronary Atherosclerosis: Gulf Left Main Registry

Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in revascularization of left main coronary artery (LMCA) disease has been evaluated in previous studies. However, there has been minimal study of the relationship between co-existing non-coronary atherosclerosis (NCA...

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Published in:	Current problems in cardiology Vol. 48; no. 1; p. 101424
Main Authors:	Daoulah, Amin, Abozenah, Mohammed, Alshehri, Mohammed, Hersi, Ahmad S., Yousif, Nooraldaem, Garni, Turki Al, Abuelatta, Reda, Almahmeed, Wael, Alasmari, Abdulaziz, Alzahrani, Badr, Ghani, Mohamed Ajaz, Amin, Haitham, Hashmani, Shahrukh, Hiremath, Niranjan, Alharbi, Ahmad W., Kazim, Hameedullah M., Refaat, Wael, Selim, Ehab, Dahdouh, Ziad, Aithal, Jairam, Ibrahim, Ahmed M., Elganady, Abdelmaksoud, Qutub, Mohammed A., Alama, Mohamed N., Abohasan, Abdulwali, Hassan, Taher, Balghith, Mohammed, Hussien, Adnan Fathey, Abdulhabeeb, Ibrahim AM, Ahmad, Osama, Ramadan, Mohamed, Alqahtani, Abdulrahman H., Ahmed, Fatima Ali, Qenawi, Wael, Shawky, Ahmed, Ghonim, Ahmed A., Jamjoom, Ahmed, El-Sayed, Osama, Elmahrouk, Ahmed, Elfarnawany, Amr, Elsheikh-Mohamed, Nezar Essam, Abumelha, Bader K., Shawky, Abeer M., Arafat, Amr A., Naser, Maryam Jameel, Elmahrouk, Youssef, Alhamid, Sameer, Lotfi, Amir
Format:	Journal Article
Language:	English
Published:	Elsevier Inc 01-01-2023
Online Access:	Get full text
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Summary:	Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in revascularization of left main coronary artery (LMCA) disease has been evaluated in previous studies. However, there has been minimal study of the relationship between co-existing non-coronary atherosclerosis (NCA) and LMCA disease revascularization. We aim to examine this relationship. The Gulf-LM study is a retrospective analysis of unprotected LMCA revascularization cases undergoing PCI with second generation drug-eluting stent vs CABG across 14 centers within 3 Gulf countries between January 2015 and December 2019. A total of 2138 patients were included, 381 with coexisting NCA and 1757 without. Outcomes examined included major adverse cardiovascular and cerebrovascular events (MACCE), cardiac and non-cardiac death, and all bleeding. In patients with NCA, preexisting myocardial infarction and congestive heart failure were more common, with PCI being the most common revascularization strategy. A statistically significant reduction in in-hospital MACCE and all bleeding was noted in patients with NCA undergoing PCI as compared to CABG. At a median follow-up of 15 months, MACCE and major bleeding outcomes continued to favor the PCI group, though no such difference was identified between revascularization strategies in patients without NCA.In this multicenter retrospective study of patients with and without NCA who require revascularization (PCI and CABG) for unprotected LMCA disease, PCI demonstrated a better clinical outcome in MACCE both in-hospital and during the short-term follow-up in patients with NCA. However, no such difference was observed in patients without NCA.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	0146-2806 1535-6280
DOI:	10.1016/j.cpcardiol.2022.101424