Percutaneous Coronary Intervention Vs Coronary Artery Bypass Surgery for Unprotected Left Main Coronary Disease: G-LM Registry

Amin Daoulah 1Abdulaziz Alasmari 2Ahmad S Hersi 3Mohammed Alshehri 4Turki Al Garni 5Reda Abuelatta 6Haitham Amin 7Wael Almahmeed 8Alwaleed Aljohar 3Bader K Abumelha 9Badr Alzahrani 5Mohamed Ajaz Ghani 6Nooraldaem Yousif 7Shahrukh Hashmani 8Salem M Al-Faifi 10Hameedullah M Kazim 11Wael Refaat 12Ziad Dahdouh 13Feras Khaliel 14Jairam Aithal 15Ahmed Elmahrouk 16Ahmed M Ibrahim 17Abdelmaksoud Elganady 18Mohammed A Qutub 19Mohamed N Alama 19Abdulwali Abohasan 20Taher Hassan 21Mohammed Balghith 22Abdulrahman M Alqahtani 23Ahmed F Abdelaziz 24Issam Altnji 25Adnan Fathey Hussien 26Ibrahim A M Abdulhabeeb 27Osama Ahmad 13Mamdouh M Haddara 28Abdulrahman H Alqahtani 29Saif S Alshahrani 30Wael Qenawi 4Mohamed H Izzeldin 4Osama El-Sayed 2Ahmed Jamjoom 2Abdulrahman Al Moghairi 5Hussein Al Amri 5Waleed Moubark Ibrahim 6Mohsen M Alarbash 6Tajammul Hussain 7Fahad Shamsi 8Ehab Selim 11Mohamed Ramadan 12Hani Al-Sergani 13Tahir Mohamed 13Abdulwahab Al Khalifa 31Niranjan Hiremath 8Amira Ali Taha Ibrahim 15Hassane Abdallah 32Amr Elprince 32Ahmed Diab 17Diaa Eldin A Seoud 33Ahmed A Alghamdi 34Khaled E Alebrahim 34Duna Basudan 35Faisal Omar M Al Nasser 6Ibrahim Ahmed Abuagila Ali 6Abeer M Shawky 18Ahmed Ghonim 19Abdullah Al Khushail 5Maun N Feteih 10Seraj Abualnaja 26Bandar Alhaddadi 22Sameer Alhamid 36Waleed A Ahmed 37Zainab M Jafary 23Samir Ahnia 27Jala Gasem 10Shahad Alaydarous 10Tamer Khatab 11Ataaelrahman Mohamed 11Mohamed Maghrabi 11Faisal Al Samadi 23Tareef H Kannout 23Najeeb Mahrous 23Yahya Almaleh 38Adil B Al Riyami 39Altayyeb Yousef 40Mohammed Ali Ahmed 41Ruqayyah Ali Ahmed 42Wael Tawfik 43Nasser Almegreb 44Mazen S Faden 45Ejazul Haq 2Salah N AlOtaibi 28Akram Eldesoky 46Francis A Clarkson 47Amir Lotfi 48

Affiliations


Abstract

Coronary artery bypass surgery (CABG) has been the standard of care for revascularization for patients with obstructive unprotected left main coronary disease (ULMCA). There have been multiple randomized and registry data demonstrating the technical and clinical efficacy of PCI in certain patients with ULMCA. The purpose of this study is to evaluate clinical outcomes of ULMCA PCI as compared to CABG in patients requiring revascularization in three Gulf countries. All ULMCA cases treated by PCI with DES versus CABG were retrospectively identified from 14 centers in 3 Arab Gulf countries (KSA, UAE, and Bahrain) from January 2015 to December 2019. In total, 2138 patients were included: 1222 were treated with PCI versus 916 with CABG. Patients undergoing PCI were older, and had higher comorbidities and mean European System for Cardiac Operative Risk Evaluation (EuroSCORE). Aborted cardiac arrest and cardiogenic shock were reported more in the PCI group at hospital presentation. In addition, lower ejection fractions were reported in the PCI group. In hospital mortality and major adverse cardiovascular and cerebrovascular events (MACCE) occurred more in patients undergoing CABG than PCI. At median follow-up of 15 months (interquartile range, 30), no difference was observed in freedom from revascularization, MACCE, or total mortality between those treated with PCI and CABG. While findings are similar to Western data registries, continued follow-up will be needed to ascertain whether this pattern continues into latter years.


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References

https://pubmed.ncbi.nlm.nih.gov/