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

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

Affiliations

10 January 2022

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doi: 10.1016/j.cpcardiol.2021.101002

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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KMEL References

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

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