Complete revascularization predicts survival in patients with ST-segment elevation myocardial infarction and primary percutaneous intervention for an unprotected left main coronary artery culprit lesion

Objective: T he correlation between the extent of re-vascularization and outcomes was evaluated in ST-seg-ment elevation myocardial infarction (STEMI) pati-ents with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery le-sion (UPLMCA).
Methods: Early and long-term outcomes were analysed in a cohort of retrospectively selected consecutive pati-ents with STEMI and primary PCI on UPLMCA.
Results: From a total of 7221 patients with acute STEMI admitted between October 2007 and March 2017, 81 had an unprotected left main coronary artery culprit le-sion. Thirty days, one year and 3.25 years mortality was 35.8%, 44.40% and 54.30% respectively. Cardiogenic shock (p=0.001), age (p=0.008), and glomerular filtra-tion rate (p=0.024) were independent mortality predic-tors at one year follow-up. Besides cardiogenic shock (p<0.001), TIMI 0/1 flow (p=0.021) and age (p=0.006), complete revascularization (p=0.011) emerged as an independent predictor of mortality at 3.25 years follow-up. In patients with TIMI 0/1 flow, the presence of right coronary artery collaterals was an independent predic-tor for long-term survival (p=0.049).
Conclusions: In patients with STEMI and primary PCI for an UPLMCA culprit lesion, complete revasculariza-tion represents an independent predictor of survival at long-term follow-up.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)