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Acute total occlusion of the unprotected left main coronary artery: Patient characteristics and outcomes

2023-08Journal article Open access
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dc.contributor.authorCalvão, João
dc.contributor.authorBraga, Marta
dc.contributor.authorBrandão, Mariana
dc.contributor.authorCampinas, Andreia
dc.contributor.authorAlexandre, André
dc.contributor.authorAmador, Ana
dc.contributor.authorCosta, Catarina
dc.contributor.authorSilva, João C.
dc.contributor.authorSilva, Marisa
dc.contributor.authorBrochado, Bruno
dc.contributor.authorFreitas, João
dc.contributor.authorMacedo, Filipe
dc.date.accessioned2024-07-23T12:00:28Z
dc.date.available2024-07-23T12:00:28Z
dc.date.issued2023-08
dc.description.abstractIntroduction and objectives: Acute total occlusion of the unprotected left main coronary artery (LMCA) is a dramatic event. There are limited data regarding this population. We aimed to describe the clinical presentation and outcomes of patients and to determine predictors of in-hospital mortality. Methods: This retrospective study included patients presenting with acute (<12 h) myocardial infarction due to total occlusion of the LMCA (TIMI flow 0) between January 2008 and December 2020 in three tertiary hospitals. Results: During this period, 11036 emergent coronary angiographies were performed, 59 (0.5%) of which revealed acute total occlusion of the LMCA. Patients' mean age was 61.2 (SD±12.2) years and 73% were male. No patients had left dominance. At presentation, 73% were in cardiogenic shock, aborted cardiac arrest occurred in 27% and 97% underwent myocardial revascularization. Primary percutaneous coronary intervention was performed in 90% of cases and angiographic success was achieved in 56% of procedures, while 7% of patients underwent surgical revascularization. In-hospital mortality was 58%. Among survivors, 92% and 67% were alive after one and five years, respectively. After multivariate analysis, only cardiogenic shock and angiographic success were independent predictors of in-hospital mortality. Use of mechanical circulatory support and presence of well-developed collateral circulation were not predictive of short-term prognosis. Conclusion: Acute total occlusion of the LMCA is associated with a dismal prognosis. Cardiogenic shock and angiographic success play a major role in predicting the prognosis of these patients. The effect of mechanical circulatory support on patient prognosis remains to be determined.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCalvão J, Braga M, Brandão M, et al. Acute total occlusion of the unprotected left main coronary artery: Patient characteristics and outcomes. Rev Port Cardiol. 2023;42(8):723-729. doi:10.1016/j.repc.2022.11.007pt_PT
dc.identifier.doi10.1016/j.repc.2022.11.007pt_PT
dc.identifier.issn0870-2551
dc.identifier.issn2174-2030
dc.identifier.urihttp://hdl.handle.net/10400.16/3023
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://doi.org/10.1016/j.repc.2022.11.007pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAcute coronary syndromept_PT
dc.subjectCardiogenic shockpt_PT
dc.subjectChoque cardiogénicopt_PT
dc.subjectLeft main coronary arterypt_PT
dc.subjectSíndrome coronária agudapt_PT
dc.subjectTronco comumpt_PT
dc.titleAcute total occlusion of the unprotected left main coronary artery: Patient characteristics and outcomespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlacePortugalpt_PT
oaire.citation.endPage729pt_PT
oaire.citation.issue8pt_PT
oaire.citation.startPage723pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume42pt_PT
person.familyNameBrochado
person.givenNameBruno
person.identifier.orcid0000-0003-0107-5023
person.identifier.scopus-author-id56019319200
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationa1fc254a-7b81-45a3-a7fe-be4e97074a39
relation.isAuthorOfPublication.latestForDiscoverya1fc254a-7b81-45a3-a7fe-be4e97074a39

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