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Left Main Percutaneous Intervention for Myocardial Infarction: a Tertiary Centre Retrospective Study
Session:
Sessão de Posters 42 - Revascularização de tronco comum
Speaker:
Tomás Carlos
Congress:
CPC 2024
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Tomás M. Carlos; Gonçalo Terleira Batista; Luísa Gomes Rocha; Luís Leite; Bernardo Lisboa Resende; Mafalda Griné; Lino Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Background:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Acute myocardial infarction due to left main coronary artery (LMCA) is an uncommon but severe condition, associated with high in-hospital morbidity and mortality. This study aimed to assess baseline and demographic characteristics of patients undergoing LMCA percutaneous coronary intervention (PCI) for myocardial infarction and compare them based on their global 1-year outcome. Moreover, we sought to identify potential predictors of survival.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Methods:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">A single-centre retrospective observational study assessed consecutive patients who underwent LMCA-PCI for both ST-elevation and non-ST-elevation myocardial infarction, from January 2020 to December 2022. Data was collected from hospital records. Elective interventions and patients with insufficient data or lost follow-up were excluded. We assessed their baseline characteristics and their global mortality rates at 30, 90 and 180 days, and 1 year. Survivors and non-survivors within 1 year were compared using parametric/non-parametric, according to the normality of the distribution, and chi-square/Fisher tests. Lastly, we performed Cox regression to identify possible predictors of survival.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Results:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">A total of 59 patients, with a mean age of 69.6 ±11.8 years and a male predominance (76%) were included. The most frequent comorbidity was hypertension (68%), followed by dyslipidaemia (64%). ST-elevation myocardial infarction (STEMI) was the most common clinical presentation (59%). All-cause mortality at 30-days was 24%, increasing to 34% at 1-year (20 patients). When comparing survivors and non-survivors at 1-year of follow-up, older age (<em>p</em>=0.019) and higher values of high-sensitivity troponin I (hsTNI) at admission (<em>p</em>=0.011) were significantly associated with mortality. No statistically significant differences were found regarding hypertension, gender, smoking, diabetes or clinical presentation. Cox regression analysis suggested hsTNI peak value in the first 72 hours as a potential predictor of survival, notwithstanding its modest hazard ratio (<em>p</em><0.001, HR 1.000003). </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">Conclusions:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Acute LMCA-PCI in our centre primarily addresses STEMI, reflecting its severity on initial presentation and mainly justifying higher short-term mortality. Older age and elevated admission hsTNI levels were associated with 1-year mortality, with peak hsTNI in the first 72 hours potentially predicting survival, despite its low hazard ratio. </span></span></span></p>
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