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ȣ - 520713 337 |
Right Coronary Artery Disease Is a Major Predictor of Adverse Clinical Outcomes in Patients with Unprotected Left Main Coronary Artery Disease |
울산대학교 의과대학 서울아산병원 심장내과 |
이명준, 김성식, 김성환, 민선양, 서정숙, 박종필, 이종영, 김경중, 이정우, 김원장, 박덕우, 이승환, 김영학, 이철환, 홍명기, 김재중, 박성욱, 박승정, MAIN-COMPARE investigators |
Background: Clinical impact of right coronary artery (RCA) involvement on long-term outcomes of patients undergoing unprotected left main coronary artery (ULMCA) revascularization has not been well known.
Methods: Between Jan, 2000 and June, 2006, a total of 2311 patients with ULMCA stenosis were enrolled from 12 academic centers in Korea. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) were performed in 1141 patients and 1170 patients, respectively.
Results: Patients with RCA disease were significantly older and had more prevalence of diabetes, hypertension, hyperlipidemia, smoking, left ventricular dysfunction (EF<40%), and high Euroscore ( 6) than those without RCA disease. During median follow-up of 37.5 months (24.4-54.8), RCA involvement was significantly associated with increase of adverse clinical events (Table).
Conclusions: The presence of RCA stenosis in patients with ULMCA lesion who underwent PCI or CABG was associated with unfavorable long-term outcome compared with those without RCA disease.
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RCA (+) |
RCA (-) |
P value* |
PCI group |
415 pts |
725 pts |
|
Death |
3.2% |
3.4% |
0.002 |
Q-MI |
0.3% |
0.5% |
0.003 |
TVR |
4.8% |
6.4% |
<0.001 |
Death/Q-MI/TVR |
7.5% |
9.5% |
<0.001 |
CABG group |
830 pts |
339 pts |
|
Death |
5.8% |
1.2% |
0.004 |
Q-MI |
1.2% |
0.1% |
0.22 |
TVR |
1.5% |
0.6% |
0.356 |
Death/Q-MI/TVR |
8.0% |
0.8% |
0.001 |
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