Clinical characteristics and outcomes of left main coronary artery intervention: A single-center registry
Main Article Content
Abstract
This observational study evaluated the clinical characteristics and one-year survival outcomes of percutaneous coronary intervention (PCI) for left main coronary artery disease at the University Medical Center Ho Chi Minh City. From March to December 2023, 69 eligible patients were enrolled and followed up for 12 months. The mean age was 66.2 ± 11.3 years old, where 50.7% had diabetes mellitus. The mean SYNTAX score was 26.6 ± 9.2, and 52.2% involved true bifurcation lesions. The primary endpoint was all-cause mortality estimated using the Kaplan-Meier method. This study showed a cumulative mortality rate of 0% at 30 days and 5.8% at one year (95% CI: 2.2% - 14.7%). In conclusion, this study suggests that left main PCI is a safe and effective strategy demonstrating low in-hospital and mid-term mortality rates, particularly in patients with low-to-intermediate anatomical complexity.
Article Details
Keywords
Left main disease, percutaneous coronary intervention, outcomes
References
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2. Dao ATM, Van Nguyen H, Nguyen HL, et al. Current Gaps in the Control of Cardiovascular Disease in Vietnam: A Systematic Review of Vietnamese-based Studies. Journal of Health Management. 2024; 26(2): 342-350. doi:10.1177/09720634241229265.
3. Kayaert P, Coeman M, Hanet C, et al. Practice and long-term outcome of unprotected left main PCI: real-world data from a nationwide registry. Acta Cardiologica. 2022; 77(1): 51-58. doi:10.1080/00015385.2021.1876402.
4. Tam DY, Fang J, Rocha RV, et al. Real-World Examination of Revascularization Strategies for Left Main Coronary Disease in Ontario, Canada. JACC: Cardiovascular Interventions. 2023; 16(3): 277-288. doi:10.1016/j.jcin.2022.10.016.
5. Rampat R, Hildick-Smith D. Left Main Stem Percutaneous Coronary Intervention - Data and Ongoing Trials. Interv Cardiol. 2015;10(3):132-135. doi:10.15420/ICR.2015.10.03.132
6. Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023; 44(38): 3720-3826. doi:10.1093/eurheartj/ehad191.
7. Rao SV, O’Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2025; 151(13): e771-e862. doi:10.1161/CIR.0000000000001309.
8. Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024; 45(36): 3415-3537. doi:10.1093/eurheartj/ehae177.
9. Phuong Le DC, The Bui H, Duy Vo Q. Percutaneous Coronary Intervention of Left Main Disease: Outcome After 1-year Follow-up at a Tertiary Hospital in Vietnam. Interv Cardiol. 2024; 19: e08. doi:10.15420/icr.2023.37.
10. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth Universal Definition of Myocardial Infarction (2018). Journal of the American College of Cardiology. 2018; 72(18): 2231-2264. doi:10.1016/j.jacc.2018.08.1038.
11. Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020; 41(3): 407-477. doi:10.1093/eurheartj/ehz425.
12. Batra G, Aktaa S, Wallentin L, et al. Data standards for acute coronary syndrome and percutaneous coronary intervention: the European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart). European Heart Journal. 2022; 43(24): 2269-2285. doi:10.1093/eurheartj/ehac133.
13. Bozkurt B, Hershberger RE, Butler J, et al. 2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure). Circulation: Cardiovascular Quality and Outcomes. 2021; 14(4): e000102. doi:10.1161/HCQ.0000000000000102.
14. Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation. 1988; 78(2): 486-502. doi:10.1161/01.cir.78.2.486.
15. Louvard Y, Medina A. Definitions and classifications of bifurcation lesions and treatment. doi:10.4244/EIJV11SVA5.
16. Chieffo A, Tanaka A, Giustino G, et al. The DELTA 2 Registry: A Multicenter Registry Evaluating Percutaneous Coronary Intervention With New-Generation Drug-Eluting Stents in Patients With Obstructive Left Main Coronary Artery Disease. JACC Cardiovasc Interv. 2017; 10(23): 2401-2410. doi:10.1016/j.jcin.2017.08.050.
17. Kandzari D, Gershlick A, Serruys PW, et al. Procedural characteristics and clinical outcomes in patients undergoing percutaneous coronary intervention for left main trifurcation disease: the EXCEL trial. doi:10.4244/EIJ-D-19-00686.
18. Ladwiniec A, Walsh SJ, Holm NR, et al. Intravascular ultrasound to guide left main stem intervention: a NOBLE trial substudy. EuroIntervention. 2020; 16(3): 201-209. doi:10.4244/EIJ-D-19-01003.
19. Lassen JF, Burzotta F, Banning A, et al. Percutaneous coronary intervention for the left main stem and other bifurcation lesions: 12th consensus document from the European Bifurcation Club. doi:10.4244/EIJ-D-17-00622.
20. Lee PH, Lee JY, Lee CW, et al. Long-term outcomes of bypass grafting versus drug-eluting stenting for left main coronary artery disease: Results from the IRIS-MAIN registry. Am Heart J. 2017; 193: 76-83. doi:10.1016/j.ahj.2017.08.003.