Background

Acute myocardial infarction (AMI) patients (pts) due to unprotected left main coronary artery (ULMCA) disease represent a rare, high risk group. Emergency percutaneous coronary intervention (PCI) may be the preferred strategy but there are limited data. We investigated early and 1-year clinical outcomes following primary PCI in AMI pts with ULMCA disease.

Method

The study population consisted of a total 47 consecutive AMI ULMCA disease underwent primary PCI between November 2004 and August 2012. GP IIb/IIIa blocker and intraarterial balloon pump support were depending on physician’s discretion. We evaluated major cumulative clinical outcomes up to 1 year.

Result

Male were in 78.7% and mean age was 66.39 ± 9.504. Half of pts were presented with STEMI (48.9%). Hypertension 66.0%, diabetes 46.8%, smoking 54.2% and mean left ventricular ejection fraction (LVEF) was 43.23± 12.26%. At 1 year, total mortality was 23.4% and target lesion revascularization (TLR) was 14.9% (table). In the multivariate logistic analysis, LVEF was an independent predictor for 1year mortality.

Conclusion

In AMI pts with ULMCA as a culprit lesion, emergency PCI is a valuable therapeutic strategy. However, the rate of major clinical events was relatively high and overall long-term survival depends on LV systolic function on arrival. Special care should be warranted.

Copyright © 2014 Published by Elsevier Inc.