Evaluation of long-term results of stenting of the unprotected left main coronary artery depending on the severity of the coronary anatomical lesion

Abstract

Objective: to evaluate the long-term results of stenting of the unprotected left main coronary artery (LMCA) in patients of different risk according to Syntax score.

Materials and methods: 282 patients who underwent stenting of unprotected LMCA were included in the follow-up. The average follow-up period was 34.6 months. Depending on the severity of the lesion, the patients were divided into low (< 22 points on the Syntax score, n = 135), medium (23-32 points, n = 93) and high-risk groups (>33 points, n = 54).

Results: the overall incidence of adverse cardiovascular events was significantly higher in the high-risk group (37%) compared with patients with Syntax < 22 (10.4%) and Syntax 23-32 (9.7%), p < 0.0001. Differences in the frequency of adverse events were due to significantly higher frequency of myocardial infarction and repeated revascularization. The frequency of death was comparable between the groups.

Conclusions: in patients with Syntax >33 the probability of adverse cardiovascular events after stenting is significantly higher than in patients with Syntax 32 and lower when using stents with antiproliferative drug coating. In patients with Syntax score 0-22 and 23-32 and the frequency of adverse cardiovascular events is comparable. At the same time, the severity of coronary lesions does not significantly affect the death rate in long term follow up after stenting of the unprotected LMCA.