Complex coronary intervention outcomes: real world left main coronary artery angioplasty experience from a tertiary care center in South India
DOI:
https://doi.org/10.18203/2349-3933.ijam20193264Keywords:
Complex angioplasty, Complex PCI, Drug eluting stent, GenxSync, left main angioplasty, Left main coronary artery stenosis, LMCA stenosisAbstract
Background: Left Main Coronary Artery (LMCA) Disease is among the most complex forms of the coronary artery stenosis, the leading cause of mortality in the world.
Methods: In this analysis, 102 patients with elective angioplasty for LMCA stenosis with PCI from 6/2013 to 5/2016, 3 years (70 in GenxSync™ arm and 32 in other devices arm; 100 DES and 2 BMS) were included. RADHIKa Analysis compared post-hoc subgroups of GenxSync™ and control groups.
Results: Mean population age was 59.99±12.03 years; 60.27±10.49 years in GenxSync™ arm, and 58.31±14.32 years in control arm. A significant population (44, 43.14%) had diabetes, renal impairment (14, 13.73%) and hypertension (25, 24.51%). The MACCE in GenxSync™ arm was 17 13(18.58%) Versus 5(15.63%) [RR=0.93, RR’=-0.07, ψ=-14.01. p=0.3). Most patients presented with unstable Angina (41, 40.20%) in all, 31(44.29%) in GenxSync™ and 10 (31.25%) in Control arm. AWMI and IWMI were 18, 17.65% each, attributed to 12 (17.14%) in GenxSync™ 6 (18.75%) in Control. Effort angina was 15(21.43%) in GenxSync™ and 10 (31.25%) in Control and NSTEMI was 25,24.51% (18 (25.71%)- GenxSync™ 7(21.88%) Control). The MACE in GenxSync™ arm at 24, 12 and 6 months was 12(17.15%), 8(11.43%) and 4(5.71%) respectively versus corresponding MACE in the control arm as 5(15.63%), 2(2.86%) and 2(6.25%) respectively. The TVR was present only in GenxSync™ Arm, which was contributed by 2 CABGs and 12 months and 1 additional PCI at 24 months.
Conclusions: In real-world scenario of LMCA cases, performance and safety of various stents were similar. GenxSync™ Sirolimus Eluting Stent, in the post-hoc bifurcation had results similar to other real-world cases, based upon RADHIKa analysis.
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