Key result
Left coronary dominance linked to ~555% higher odds of adverse in-hospital outcomes vs right/co-dominant anatomy.
Why the study?
Does left coronary dominance increase the risk of in-hospital adverse outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention?
Observational (n=149)
No
Does left coronary dominance increase the risk of in-hospital adverse outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention?
Odds Ratio: 6.553
Absolute Event Rate: 23.1% vs 5.7%
p-value: p=<0.05
Left coronary dominance is associated with a significantly higher risk of in-hospital adverse outcomes, including arrhythmia and cardiogenic shock, in ACS patients undergoing PCI.
Should not yet alter PCI risk stratification in ACS; leaves open whether coronary dominance warrants targeted monitoring in prospective studies.
Background: Coronary dominance affects on in-hospital outcomes of patients with acute coronary syndrome and also affects the outcome following percutaneous coronary intervention. Left dominant anatomy is believed to be associated with worse prognoses for patients with acute coronary syndrome undergoing percutaneous coronary. This study evaluated the manner in which coronary dominance affects in-hospital adverse outcomes of acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI).Methods: Data were analyzed from 149 ACS patients who underwent PCI between November 2014 and October 2015 at National Institute of Cardiovascular Diseases (NICVD), Dhaka. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right dominant plus co-dominant anatomy (RD+Co group) and those with left dominant anatomy (LD group).Results: Total adverse in-hospital outcome is 8.7% patients. In LD group 23.1% patients were experienced adverse in-hospital outcome, on the contrary 5.7% of the patients with RD+Co group did have such experience. About 2.7% patients developed arrhythmia, 2.7% cardiogenic shock, 2% acute left ventricular failure and 0.7% ischaemic chest pain of the both groups. Among them arrhythmia, acute left ventricular failure and cardiogenic shock were more common in LD group than RD+Co (7.7% vs. 1.6%, 7.7% vs. 0.8% and 7.7% vs. 1.6%) group. Multivariate logistic regression analysis revealed that smoking, diabetes mellitus and left coronary dominance were the independent predictors for developing adverse in-hospital outcome with ORs being 1.317, 1.074 and 6.553 respectively (p <0.05).Conclusion: Patients of left coronary dominant had higher in-hospital adverse outcome compared with patients of right dominant plus co-dominant in a population with acute coronary syndrome who underwent percutaneous coronary intervention and left dominant anatomy was an independent predictor for developing adverse in-hospital outcome.Cardiovasc. j. 2017; 9(2): 129-134
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Hossain et al. (2017) conducted an observational in Acute coronary syndrome (n=149). Left coronary dominance vs. Right dominant plus co-dominant anatomy was evaluated on Adverse in-hospital outcome (OR 6.553, p=<0.05). Left coronary dominance independently predicted adverse in-hospital outcomes compared to right or co-dominant anatomy in ACS patients undergoing PCI (23.1% vs 5.7%; OR 6.553, p<0.05).
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