Key result
PCI may improve outcomes in unprotected left main ACS, particularly if performed prior to shock.
Why the study?
Patients with acute coronary syndrome from unprotected left main coronary stenosis have very high mortality, and optimal percutaneous management strategies need clarification.
Answers are grounded in this paper and cite their sources.
This review highlights the high mortality risk of ACS from unprotected left main disease and proposes a clinical algorithm for evaluation and treatment using percutaneous coronary intervention.
The patient with acute coronary syndrome, particularly with myocardial infarction, from an unprotected left main coronary stenosis represents one of the highest risk subgroups with mortality exceeding 25-50%. Once a patient develops cardiogenic shock, the risk of death during index hospitalization is exceedingly high. Percutaneous coronary intervention may improve short- and long-term outcome, particularly if performed prior to shock development. Should the patient survive index hospitalization, survival tends to be rather good. This review summarizes current knowledge and proposes a clinical algorithm for evaluation and treatment.
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Uretsky et al. (2015) conducted a review in Acute coronary syndromes from unprotected left main disease. Percutaneous coronary intervention was evaluated. Percutaneous coronary intervention may improve short- and long-term outcomes in patients with acute coronary syndromes from unprotected left main disease, particularly if performed prior to shock.
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