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Percutaneous revascularization of left main coronary artery in diabetic patients
Session:
Sessão de Posters 42 - Revascularização de tronco comum
Speaker:
Lucas Hamann
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:
Lucas Hamann; Joana Massa Pereira; Sofia Andraz; Hugo Costa; Miguel Espírito Santo; Jorge Mimoso
Abstract
<p>Introduction: The treatment of choice of left main coronary artery (LMCA) disease has been subject to intense debate and investigation in the last decade, mainly in diabetic patients, where surgical revascularization is the standard of care. Angioplasty of LMCA in diabetics has been increasing mainly in non-complex coronary artery disease patients.</p> <p>Objective: Characterize the population submitted to LMCA angioplasty. Compare cardiovascular (CV) mortality, acute coronary syndromes (ACS) and the need of re-vascularization (composite primary outcome) regarding the presence of type 2 diabetes (T2DM), in 2 years follow-up. Try to identify prognostic factors for the primary outcome.</p> <p>Methods: Retrospective study between 2019/2020, composed of n=120 patients who submitted to LMCA angioplasty. Two groups were created regarding the presence of T2DM. Categorical variables are presented as frequencies and percentages, and continuous variables as means and standard deviations, or medians and interquartile ranges for variables with skewed distribution or a significant Shapiro-Wilk test. Multivariate analysis was performed using logistic regression. P value < 0.05 indicates statistical significance.</p> <p>Results: A total of 120 patients were identified, with a mean age of 70.5 ± 10.8 years, 76.7% were male. T2DM group was composed by 41 (34.2%) patients. 75% had hypertension, 60.8% dyslipidemia, 20.2% obesity, 21.7% were smoker and 8.3% chronic renal disease (CRD). Age, obesity, smoking status and CRD were more frequent in T2DM population. 72.5% presented with ACS and 55% had left main plus one atherosclerotic coronary artery disease. Overall, improvement of LVEF after procedure was 6% (p<0.001). Euroscore and syntax score > 22 were higher in T2DM patients (p<0.001, p<0.001). Primary outcome (composite) occurred in 21 (18.6%) patients, without differences between groups (T2DM n=10, 25.6% vs n=11, 14.9%, p=0.161). Individual components of primary outcome also without statistical significance in 2 years follow-up. T2DM was not an independent predictor of the primary outcome (p=0.813, OR 0.86, 95% CI 0.26 to 2.89).</p> <p>Conclusion: In the sample analyzed, T2DM patients submitted to LMCA angioplasty had low rates of hard CV outcomes and improvement of LVEF without differences when compared with non-T2DM group, showing the benefit of this revascularization strategy in these patients.</p>
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