Why the study?
Does left main coronary artery disease carry a higher mortality risk and different clinical profile compared to severe 3-vessel disease?
Does left main coronary artery disease carry a higher mortality risk and different clinical profile compared to severe 3-vessel disease?
In a Middle Eastern cohort, left main coronary artery disease was associated with higher 1-year mortality compared to severe 3-vessel disease, and renal failure was a strong independent predictor of LMCA.
May warrant renal monitoring in high-risk CAD; extends LMCA-mortality link to Middle Eastern cohorts but leaves generalizability open.
We evaluated the prevalence and clinical profile of patients with left main coronary artery disease (LMCA) in Qatar between 2006 and 2010. Patients were divided into 2 groups: patients with LMCA and patients without LMCA but had severe 3-vessel disease (VeD) eligible for surgical revascularization. Among 7000 patients who underwent coronary angiography, 210 patients had significant LMCA and 200 patients with severe 3VeD were matched for age and sex. Diabetes mellitus and hypertension were comparable in the 2 groups. Presentations with myocardial infarction or heart failure were comparable in both groups. Isolated LMCA was 4-fold higher in women (P = .02). Dyslipidemia and smoking were more prevalent in patients with distal and proximal lesions, respectively. Renal failure was independent predictor of LMCA (adjusted odds ratio: 2.6; 95% confidence interval: 1.43-4.69). One-year mortality was higher in LMCA (P = .01). The LMCA carries high mortality. Certain cardiovascular risk factors were important predictors of stenosis site.
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Gehani et al. (2012) studied this question.
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