Long Term Outcome of Unprotected Left Main Stem Percutaneous Coronary Intervention, a Single Centre Experience.

Percutaneous coronary intervention (PCI) is increasingly used for unprotected left main coronary artery disease (UPLMS) revascularization. Data regarding long-term mortality in this subset of patients remain sparse. We aim to present our outcome data on all comers who had UPLMS PCI. Methods: Retrospective dataset analysis of prospectively collected data evaluating all UPLMS PCI performed in a large tertiary cardiac centre, between September 2003 and December 2012. Long-term mortality data were available over a median duration of 21 months (IQR 10 months to 43 months). Results: In total there were 483 procedures performed. The cohort consisted of 58% with non ST elevation myocardial infarction (NSTEMI), 17% with STEMI and 25% with stable angina (SA). The overall in-hospital and long-term mortality were 7% and 22% respectively. The in-hospital mortality was 23%, 6%, and 1.6% in STEMI, NSTEMI, and SA respectively. Long-term mortality was 31% in STEMI patients, 26% in NSTEMI and 10% in SA. The use of drug eluting stents (DES) [adjusted RR 0.40 (95% CI, 0.23-0.69)] and Intravascular ultrasound (IVUS) [adjusted RR 0.17 (95% CI 0.04-0.72)] were independently associated with improved long-term survival. Conclusion: UPLMS PCI is associated with favourable long-term survival. The use of DES and IVUS guided PCI appear to be associated with improved long-term outcome and should be considered in the routine management of this cohort of patients. [ABSTRACT FROM AUTHOR]