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Limits: Publication Date from 2003/10/01 to
2005/02/01

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1: Int J
Cardiol. 2004 Oct;97(1):73-6.

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Early and late clinical
outcomes after primary stenting of the unprotected left main coronary
artery stenosis in the setting of acute myocardial
infarction.

Lee SW, Hong MK, Lee CW, Kim YH, Park
JH, Lee JH, Han KH, Kim JJ, Park SW, Park SJ.

Department of
Internal Medicine, University of Ulsan College of Medicine, Asan Medical
Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, South
Korea.

BACKGROUND: Acute left main coronary artery occlusion is a
dramatic condition with very high mortality. The study was aimed to
evaluate the effect of primary stenting in patients with left main
coronary artery (LMCA) disease in the setting of acute myocardial
infarction (AMI). METHODS: Between June 1997 and April 2002, primary
stenting for left main coronary artery disease was performed in 18
patients with acute myocardial infarction. We evaluated early and late
clinical outcomes, and prognostic determinants in this clinical setting.
RESULTS: Mean ages of patients were 59 +/- 12 years. Fourteen patients
had cardiogenic shock on admission. Angiographic success (TIMI flow >
or = 2 and diameter stenosis < 30% after stenting) was achieved in 17
patients (94%). In-hospital death occurred in eight patients (44%). Two
patients (11%) received emergent bypass surgery because of hemodynamic
instability after primary stenting. On univariate analysis, good
pre-intervention TIMI flow (grade > or = 2) was identified as a good
prognostic determinant of in-hospital survival. During mean follow-up of
39 +/- 22 months, there was no late death and one patient received
bypass surgery. Probability of freedom from death at 3-year was 56 +/-
12%. CONCLUSION: Primary stenting is a valuable therapeutic strategy for
left main coronary disease in the setting of acute myocardial
infarction, and it might save the life especially in patients with good
pre-intervention TIMI flow (grade > or = 2). Long-term clinical
outcome of patients surviving to hospital discharge is favorable.
Copyright 2003 Elsevier Ireland Ltd.

PMID: 15336810 [PubMed - in
process]

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