Key result
PCI is linked to ~160% higher hospital mortality versus no revascularization despite improved post-discharge survival.
Why the study?
Does revascularization (PCI or CABG) improve survival compared to no revascularization in patients with acute coronary syndromes and unprotected left main coronary disease?
Cohort (n=1,799)
Yes
Does revascularization (PCI or CABG) improve survival compared to no revascularization in patients with acute coronary syndromes and unprotected left main coronary disease?
Hazard Ratio: 2.6 (95% CI 1.62–4.18)
In patients with ACS and unprotected left main coronary disease, both PCI and CABG improve 6-month survival compared to no revascularization, with PCI more commonly used in higher-risk, unstable patients.
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PCI may raise early mortality in higher-risk patients; leaves open revascularization benefit in ACS with unprotected left main disease.
Montalescot et al. (2009) conducted a cohort in Acute coronary syndromes with unprotected left main coronary disease (n=1,799). Percutaneous coronary intervention (PCI) vs. No revascularization was evaluated on Hospital death (HR 2.60, 95% CI 1.62-4.18). Compared to no revascularization, PCI was associated with higher hospital mortality (HR 2.60; 95% CI 1.62-4.18), but both PCI and CABG improved survival from discharge to 6 months.
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