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Trends in Clinical Practice and Outcomes After Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery

Mohammad, Moman A. (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
Persson, Jonas (författare)
Karolinska Institutet
Buccheri, Sergio (författare)
Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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Odenstedt, Jacob (författare)
Sahlgrenska University Hospital,Gothenburg Univ, Sahlgrenska Univ Hosp, Dept Cardiol, Gothenburg, Sweden.
Sarno, Giovanna (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
Angerås, Oskar (författare)
Sahlgrenska University Hospital,Gothenburg Univ, Sahlgrenska Univ Hosp, Dept Cardiol, Gothenburg, Sweden.
Völz, Sebastian (författare)
Sahlgrenska University Hospital,Gothenburg Univ, Sahlgrenska Univ Hosp, Dept Cardiol, Gothenburg, Sweden.
Tödt, Tim (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
Götberg, Matthias (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
Isma, Nazim (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
Yndigegn, Troels (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
Tydén, Patrik (författare)
Lund University,Lunds universitet,Heart Failure and Mechanical Support,Forskargrupper vid Lunds universitet,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
Venetsanos, Dimitrios (författare)
Karolinska University Hospital,Karolinska Inst Solna, Dept Cardiol, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden.
Birgander, Mats (författare)
Lund University,Lunds universitet,Lund University Bioimaging Center,Medicinska fakulteten,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
Olivecrona, Göran K. (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.
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 (creator_code:org_t)
John Wiley & Sons, 2022
2022
Engelska.
Ingår i: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 11:7
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • BACKGROUND: The use of percutaneous coronary intervention (PCI) to treat unprotected left main coronary artery disease has expanded rapidly in the past decade. We aimed to describe nationwide trends in clinical practice and outcomes after PCI for left main coronary artery disease. METHODS AND RESULTS: Patients (n=4085) enrolled in the SCAAR (Swedish Coronary Angiography and Angioplasty Registry) as undergoing PCI for left main coronary artery disease from 2005 to 2017 were included. A count regression model was used to analyze time-related differences in procedural characteristics. The 3-year major adverse cardiovascular and cerebrovascular event rate defined as death, myocardial infarction, stroke, and repeat revascularization was calculated with the KaplanMeier estimator and Cox proportional hazard model. The number of annual PCI procedures grew from 121 in 2005 to 589 in 2017 (389%). The increase was greater for men (479%) and individuals with diabetes (500%). Periprocedural complications occurred in 7.9%, decreasing from 10% to 6% during the study period. A major adverse cardiovascular and cerebrovascular event occurred in 35.7% of patients, falling from 45.6% to 23.9% (hazard ratio, 0.56; 95% CI, 0.41–0.78; P=0.001). Radial artery access rose from 21.5% to 74.2% and intracoronary diagnostic procedures from 14.0% to 53.3%. Use of bare-metal stents and first-generation drug-eluting stents fell from 19.0% and 71.9%, respectively, to 0, with use of new-generation drugeluting stents increasing to 95.2%. CONCLUSIONS: Recent changes in clinical practice relating to PCI for left main coronary artery disease are characterized by a 4-fold rise in procedures conducted, increased use of evidence-based adjunctive treatment strategies, intracoronary diagnostics, newer stents, and more favorable outcomes.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

PCI
unprotected left main coronary artery disease
PCI

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