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The impact of Left Main Coronary Artery Angioplasty on Left Ventricular Function: 2-year experience in angiography laboratory.
Session:
Posters - H. Interventional Cardiology and Cardiovascular Surgery
Speaker:
Hugo Costa
Congress:
CPC 2021
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Posters
FP Number:
---
Authors:
Hugo Alex Costa; Teresa Mota; Miguel Espírito Santo; Raquel Fernandes; João Bispo; Daniela Carvalho; Ana Marreiros; Hugo Palmeiro; João Guedes; Hugo Vinhas; Jorge Mimoso; Ilídio Jesus
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction: </strong>The treatment of choice of left main coronary artery (LMCA) disease has been subject to intense debate and investigation in the last decade. More recent studies showed benefit of percutaneous coronary intervention (PCI) in patients with less complex coronary anatomy and good left ventricular function (LVEF). Although it is not the standard treatment, the use of this technique has been increasing.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objectives: </strong>Analyze the impact of LMCA PCI on left LVEF, defined by its recovery (positive variation-PV). Also analyze the profile of patients with greater cardiac functional benefit.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong>Observational and retrospective study with descriptive and comparative analysis of patients undergoing LMCA PCI, 1 January 2019 and 31 December 2020. Descriptive analysis was carried out regarding the demographic and clinical characteristics of the patients. Chi-Square test was used for categorical variables and the T-Student test for numerical variables, with a significance level of 95%. CHIAD algorithm was applied to identify patient profiles, whose dependent variable was LVEF variation, and fixed 15 parent nodes and 5 children nodes. For statistical analysis, SPSS 24.0 was used.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> N120 patients were identified, with a mean age of 70,4 years (standard deviation of 10.8), 76% were male. 81.7% had multivessel disease, with LMCA-anterior descendig artery injury being the most frequent in 31.7%. The average LVEF was 49,4% with standard deviation of 11,2. 82.5% of patients had PV, on average rising 20%. Patients who benefited the most were those with LVEF ≤ 56% (88.7% PV - p = 0.031), compared to those with LVEF> 56% (56.5% PV - p = 0.031). In a logic of dependency and profiles, patients with LVEF ≤ 56% (88.7% PV - p = 0.031), who do not develop symptoms / occurrences at 30D (94.5% PV - p = 0.013), without complications during PCI (96.9% of PV - p = 0.006) and with shorter procedures <161m (100% of PV - p = 0.004) are those with the highest PV of LVEF.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion: </strong>This analysis highlights the experience of the angiography laboratory. In this pool of patients, the average LVEF was 49%. The majority of patients recovered from LVEF, rising by an average of 20%. Lower LVEF patients appear to have a greater potential for left ventricular recovery. The analysis suggests that the benefit were greater in patients with LVEF ≤ 56% that didn´t develop symptoms or complications and had shorter procedures.</span></span></p>
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