Pre-procedure cardiogenic shock and older age tied to mortality in left main stem-PCI: Study

UK: Pre-procedure cardiogenic shock and older age are associated with an increased risk of 30-day mortality following left main stem percutaneous coronary intervention (LMS-PCI), according to a recent study in Catheterization and Cardiovascular Interventions. 

Left main stem percutaneous coronary intervention, a complex high-risk procedure, can be performed as an alternative to coronary artery bypass graft (CABG) procedure in patients with surgical turn-down or where there is equipoise in surgical versus percutaneous strategies. Current guidelines have indicate that PCI is a suitable alternative to CABG in patients with low SYNTAX score and unprotected LMS disease. However, there is limited "real world" data on outcomes of LMS-PCI. 

Against the above background, Elliott J. Carande, Department of Cardiology, Morriston Cardiac Centre, Swansea, UK, and colleagues aimed to determine and quantify mortality predictors after LMS-PCI. 

The researchers identified all LMS-PCI cases from 2016 to 2020 using local coronary angioplasty registries from two UK centers. The association between baseline and procedural characteristics were examined with 30-day and 12-month mortality using multivariate logistic regressions and descriptive statistics. A total of 484 cases of LMS-PCI were identified between 2016 and 2020.