Background Coronary artery bypass graft surgery is the standard treatment of

Background Coronary artery bypass graft surgery is the standard treatment of unprotected left main coronary stenosis (ULMCA). follow-up major adverse cardiac event (MACE) occurred in 9 patients (10.5%). Our study revealed significantly greater MACE in patients with distal left main lesion with LVEF ≤45% (50% vs 6.38% was defined as elevation of the serum creatinine kinase isoenzyme MB (CK-MB) to 3-times the upper limit of normal in the absence of new pathological Q-waves. was defined as the development of new pathological Q-waves in 2 or more contiguous leads with or without CK-MB elevation above normal. was defined as the occurrence after hospital discharge of any value of troponin and/or CK-MB greater than the upper limit of normal if associated with clinical and/or electrocardiographic changes. was defined as any repeat PCI or surgical bypass of any segment of the target vessel defined as the entire major coronary vessel proximal and distal to the target lesion including upstream and downstream branches and the target lesion itself. was defined as any repeat PCI of the target lesion or bypass surgery of the target vessel performed for restenosis. The was defined as the treated segment from 5?mm proximal to 5?mm distal to the stent. Definite probable and possible ST were determined according to the ARC definitions.20 Statistical analysis. Data are presented in percentages and mean?±?S.D. Categorical variables are presented as percentages and compared with chi-square testing. Statistical significance was established at value 0.007 (Fig. 1). Also in patients with distal ULMCA lesion those with LVEF ≤45% had significantly greater incidence of MACE than Mouse monoclonal to BMX those with LVEF?>?45% (50% vs 6.38% HR?=?10.04 value 0.007. Table 4 Incidence of MACE in different subgroups of the study population. Patients with distal lesion and diabetes had higher but statistically non-significant MACE compared to those with distal lesion and no diabetes (17.95% vs PIK-93 0% p?=?0.08). But as a whole patients with diabetes had a significantly higher MACE (p?=?0.03). Incidence of MACE with distal lesion treated by different techniques did not vary significantly. Incidence of MACE did not differ significantly in patients with distal ULMCA lesion treated with single- or double-stent strategy (p?=?0.19) (Table 5). Table 5 Incidence of MACE in patients with distal LMCA lesion. IC Stent or PIK-93 IVUS use was not associated with significant difference in incidence of MACE in patients with non-distal/distal PIK-93 lesion in this study cohort (Table 5 Table 6). Table 6 Incidence of MACE in patients with No distal LMCA lesion. All MACE found in our study occurred within 1 year of index procedure. Kaplan-Meier analysis of survival free of MACE was found to be 89.5% in these patients at 1-year follow-up (Fig. 2). Fig. 2 MACE free survival of overall population with ULMCA PCI with data showing population at risk. 4 The study was conducted with PIK-93 the purpose of analyzing the ULMCA PCI patients in a real world scenario. The longest available follow-up in our study is 6.3 years and a median follow-up of 34.6 months. During hospital stay no patient had PIK-93 MACE. During follow up period MACE occurred in 10.5% patients. The major findings of this study are: (1) PCI of patients with ULMCA disease with DES is a viable option in view of a promising survival rate; (2) age sex or type of stenting technique did not affect MACE; (3) in patients with diabetes compromised LV function (EF ≤45%) and high SYNTAX score MACE rate are high; (4) patients with distal ULMCA lesion with LV dysfunction (EF ≤45%) had significantly higher MACE; (5) patients with distal ULMCA lesion and high SYNTAX score had significantly higher MACE and (6) Use of IVUS and ESV (IC Stent) technology is not associated with lower incidence of MACE. Several trials have presented outcomes of ULMCA PCI using DES over the recent years.21 22 23 24 Results reported in these studies vary widely due to variation in patient selection and procedural technique. Most of these studies have shown that lesions involving left main ostium and shaft have better outcomes than distal left main lesions in terms of MACE. Significantly higher MACE was.