12-MONTHS RESULTS OF LEFT MAIN STENTING IN PATIENTS WITH HIGH SYNTAX SCORES

Aim. To compare the safety and efficacy of stenting of the left main coronary artery (LMCA) in patients with moderate to high risks estimated with the SYNTAX score.

Methods. 112 patients with multivessel coronary disease and LMCA disease (SYNTAX score ≥23) and severe comorbidities were included in the study. All patients were deemed ineligible for CABG by the Heart Team. Patients were assigned to two groups according to the Syntax scores: Group 1 – patients with the SYNTAX scores of 23–32 (n = 66), and Group 2 patients with the SYNTAX scores of >32 (n = 46).

Results. 107 patients completed the 12-months follow-up. 5 patients in Group 1 and 2 patients in Group 2 were lost to follow up. Myocardial infarction (MI) (8.06% versus 13.33%, p = 0.37757) and heart mortality (6.45% versus 6.67%, p = 0.9646) cumulative rates were similar within the 12-month follow-up. There were no strokes or noncardiac deaths in both groups. The 12-month confirmed rate of stent thrombosis in Groups 1 and 2 did not differ statistically (3.23% vs. 6.67%, p = 0.4051). The unadjusted model (effects of variables on survival) reported that age (OR 1.15 (95% CI 1.05– 1.26), p = 0.0032), pulmonary hypertension (OR 1.05 (95% CI 1.01–1.09), p = 0.0111) and mitral insufficiency (OR 2.65 (95% CI 1.13–6.21), p = 0.0252) affected the composite endpoint. The adjusted model determined that only age affected the prognosis (OR 1.17 (95% CI 1.05–1.29), p = 0.0038).

Conclusion. The first results of our study showed that stenting of LMCA in patients with moderate to high SYNTAX scores is a possible option and comparable with the 12-month follow-up. Age is as an independent predictor of future adverse events. Further evaluation of this complex patient cohort is required. 

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