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Year : 2020  |  Volume : 8  |  Issue : 3  |  Page : 138-143

Short-term outcomes of left main coronary artery disease treatment: A comparative study of optimal medical therapy, coronary artery bypass grafting, and percutaneous coronary intervention

1 Deparment of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
2 Department of Cardiology, Apollo Hospitals, Secundrabad, Telangana, India

Correspondence Address:
Dr. Monika Bhandari
Department of Cardiology, King George's Medical University, Lucknow - 226 003, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/heartindia.heartindia_23_20

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Background: Several studies have compared treatment strategies in patients with left main coronary artery (LMCA) disease. However, short-term outcomes have scarcely been reported. Materials and Methods: In this prospective, single-center, descriptive study, conducted between January 1, 2017, and January 1, 2018, patients with LMCA disease were treated through medical follow-up (MFU), percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG). Results: A total of 149 patients participated in the study. Of the 149 patients, 27 (18.1%), 69 (46.3%), and 53 (35.6%) patients were treated with CABG, MFU, and PCI, respectively. The SYNTAX score was 31.0 ± 5.8, 29.9 ± 7.0, and 21.0 ± 6.8 in the CABG, MFU, and PCI groups (P<0.001), respectively. At the 6-month follow-up, 19 (76.0%) and 38 (76.0%) patients presented with New York Heart Association (NYHA) Class I dyspnea in the CABG and PCI groups, respectively, as compared to 29 (59.2%) patients in the MFU group (P = 0.139). Similarly, 22 (88.0%) and 43 (86.0%) patients presented with NYHA Class I angina in the CABG and PCI groups, respectively, as compared to 27 (55.1%) patients in the MFU group (P = 0.033). Death occurred in 1 (3.7%), 10 (17.2%), and 2 (3.8%) patients in the CABG, MFU, and PCI groups (P = 0.033), respectively. Diabetics accounted for 9/13 (69.2%) of the patients who died (P = 0.012). Conclusion: Optimal medical therapy did not provide any 6-month survival benefits in patients with LMCA disease. However, CABG and PCI present as suitable treatment options for this subset of patients. The majority of the patients who presented with dyspnea and NYHA Class I belonged to the PCI and CABG groups.

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