Urgent percutaneous coronary intervention in unprotected left main. Predictors of mortality and analysis of cardiogenic shock

摘要

Background: Percutaneous coronary intervention (PCI) is mandatory in acute myo-cardial infarction (AMI) due to unprotected left main coronary artery disease (ULM) specially when is associated to cardiogenic shock (CS). Methods: We evaluated the intra- and extra-hospital mortality, and its predictors; and events in the long-term follow-up in 71 consecutive patients underwent urgent PCI with an ULM lesion. Results: 42 patients presented AMI (59% with ST segment elevation). Forty seven (66%) presented with CS or they developed it during PCI. Intrahospital mortality (IHM) was similar regardless of whether there was ST segment elevation or not. Incomplete revascularization (OR5,1 IC[l-26]) and shock (OR4,5[IC1,1-18]) were the multivariate predictors associated with a higher rate of IHM. Conclusion: Emergency PCI of the ULM has a high rate of IHM, independently of ST elevation and especially if it is associated with shock and complete revascularization is not achieved.