Fahmy, A., Ahmed, K., Thakeb, Y., Khairy, H. (2023). Percutaneous Coronary Intervention in Patients with Left Main Coronary Artery Disease and Cardiogenic Shock. The Egyptian Journal of Hospital Medicine, 90(1), 1826-1830. doi: 10.21608/ejhm.2023.284339
Ahmed Galal Fahmy; Khaled S. Ahmed; Yosry M Thakeb; Hatem Khairy. "Percutaneous Coronary Intervention in Patients with Left Main Coronary Artery Disease and Cardiogenic Shock". The Egyptian Journal of Hospital Medicine, 90, 1, 2023, 1826-1830. doi: 10.21608/ejhm.2023.284339
Fahmy, A., Ahmed, K., Thakeb, Y., Khairy, H. (2023). 'Percutaneous Coronary Intervention in Patients with Left Main Coronary Artery Disease and Cardiogenic Shock', The Egyptian Journal of Hospital Medicine, 90(1), pp. 1826-1830. doi: 10.21608/ejhm.2023.284339
Fahmy, A., Ahmed, K., Thakeb, Y., Khairy, H. Percutaneous Coronary Intervention in Patients with Left Main Coronary Artery Disease and Cardiogenic Shock. The Egyptian Journal of Hospital Medicine, 2023; 90(1): 1826-1830. doi: 10.21608/ejhm.2023.284339
Percutaneous Coronary Intervention in Patients with Left Main Coronary Artery Disease and Cardiogenic Shock
Department of Cardiology, National Heart Institute, Cairo, Egypt.
Abstract
Introduction: Cardiogenic shock of patients with myocardial infarction still affects between 3-10% of patients, and the in-hospital death rate is <30%. One of the challenges is the left main (LM) coronary intervention. Objective: The aim of the current study is to investigate the short-term outcome of emergency LM coronary intervention. Patients and methods: A total of 80 patients who underwent percutaneous coronary intervention (PCI) of LM in the setting of cardiogenic shock in our hospital were retrospectively studied. Short-term clinical outcomes and PCI characteristics were evaluated. Results: LM was the culprit artery in ]about 62.8% of the patients. The remaining cases were treated due to persistence of cardiogenic shock after successful PCI of the culprit vessel. About 43.6% of the patients had Syntax scores more than 32, and the majority of them had complicated coronary stenosis. Second stent method at the LM bifurcation was employed in 12.8% of cases, complete revascularization in 34.6%, and intra-aortic balloon pump (IABP) in 13.1%. Mortality in hospitals was 48.7%. Half of the patients had no differences between 1 or 2 stent LM bifurcation procedures at 90 days’ follow-up. Patients with incomplete revascularization with a residual Syntax score of 15 or more and those with thrombolysis in myocardial infarction (TIMI) flow. Conclusion: Neither the use of IABP nor the 2-stent approach in the LM showed a decreased short-term mortality in patients who first presented with cardiogenic shock and LM illness. However, in our study, patients with ultimate TIMI flow <III showed greater short-term mortality.
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