• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

PCI for unprotected left main coronary artery stenosis still performed infrequently

byJames EnglandandAnees Daud
January 4, 2019
in Cardiology, Surgery
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Revascularization with percutaneous coronary intervention (PCI) of unprotected left main (ULM) artery remains an infrequently performed procedure in the United States.

2. The patients undergoing PCI for ULM disease are older, with greater comorbidities, and more adverse outcomes than the clinical trial populations.

Evidence Rating Level: 3 (Average)       

Study Rundown: Left main coronary artery stenosis, referred to as unprotected left main artery disease if it has not been revascularized with a bypass graft, has traditionally been treated by surgical intervention with coronary artery bypass grafting (CABG) as the preferred management. Use of PCI for ULM disease has usually been reserved for those not felt to be surgical candidates. Recent trials have examined the efficacy of PCI for left main disease in a time period of modern PCI technology. While producing conflicting results, these trials provide data that implies PCI is a reasonable management option for patient with ULM disease. The current study sought to evaluate the impact of these modern trials on practice patterns in the United States. The study found that PCI for ULM disease is still uncommonly performed and that the people receiving PCI were older, with more comorbidities and had more adverse events than the population included in recent clinical trials.

The strengths of the study included the large study population in a modern cohort receiving current PCI technology. The main limitations of the study included the observational, cross-section design, and lack of long-term follow-up for included patients. Data on anatomic complexity, an important determinant of PCI feasibility, was also not available.

Click to read the study in JAMA Cardiology

Relevant Reading: Left Main Revascularization With PCI or CABG in Patients With Chronic Kidney Disease – EXCEL Trial

RELATED REPORTS

CT associated with lower complication risks than invasive coronary angiography

Computed tomography a suitable diagnostic alternative for obstructive coronary artery disease

Coronary artery bypass grafting reduces rate of myocardial infarctions compared to percutaneous coronary intervention for left main coronary artery disease

In-Depth [cross-sectional study]: The study looked at trends for PCI and CABG for patients with unprotected left main artery disease. Patients were included if they received PCI between 2009 and 2016, and were excluded if they had prior CABG, presented with cardiogenic shock, or cardiac arrest, or received angioplasty alone without stenting. The study included patients at more than 1600 institutions across the United States. The main outcome was in-hospital major adverse clinical events (MACE), which was a composite of death, myocardial infarction (MI), stroke, or emergent CABG.

For the 3,342,162 patients who underwent PCI only 33,128 (1%) underwent unprotected left main PCI. The rate of ULM PCI increased over time from 0.7% to 1.3%. Patients who had ULM PCI had higher rates of MACE compared to the other patients receiving PCI (9.0% [2993] vs 2.6% [86 940]; P < .001). Compared with modern clinical trials, the cohort receiving ULM PCI in this study were older and had more medical comorbidities.

Image: PD

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: coronary artery disease (CAD)left main coronary artery
Previous Post

Quick Take: Effect of intranasal ketamine vs. fentanyl on pain reduction for extremity injuries in children: the PRIME randomized clinical trial

Next Post

#VisualAbstract: Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

RelatedReports

PCI not superior to medical therapy alone in stable coronary disease: The COURAGE study
Cardiology

CT associated with lower complication risks than invasive coronary angiography

May 13, 2022
Patient Basics: Atherosclerosis
Cardiology

Computed tomography a suitable diagnostic alternative for obstructive coronary artery disease

March 14, 2022
Cognitive outcomes in older adults undergoing cardiovascular procedures unclear
Cardiology

Coronary artery bypass grafting reduces rate of myocardial infarctions compared to percutaneous coronary intervention for left main coronary artery disease

January 20, 2022
Cardiology

Cardiovascular events are associated with mental stress-induced ischemia in patients with stable coronary heart disease

November 11, 2021
Next Post
#VisualAbstract: Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

#VisualAbstract: Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

Medical home linked to lower pediatric readmission rate

Quick Take: Association of extending hospital length of stay with reduced pediatric hospital readmissions

Using HEART score to risk stratify patients with chest pain is safe but underutilized in the ED

The REDUCE-IT trial: Icosapent ethyl reduces ischemic event risk in patients with hypertriglyceridemia despite statin use

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • #VisualAbstract: Bimekizumab shows a favourable 2-year safety profile in patients with moderate to severe plaque psoriasis
  • Medical cannabis provides little improvement to sleep in chronic pain patients
  • Alzheimer disease in individuals with Down syndrome has similar variability in age of onset and mortality rate as autosomal dominant forms
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.