Assessment of acute coronary syndromes among patients with left main coronary artery disease in centers with and without cardiac surgery on-site. Data from PL-ACS registry.

Cardiology journal Pub Date : 2025-01-01 Epub Date: 2025-05-21 DOI:10.5603/cj.98087
Karol Śmiech, Krzysztof Brust, Kamil Bujak, Mariusz Gąsior, Tomasz Roleder
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Abstract

Background: The treatment of left main coronary artery disease (LMCAD) in acute coronary syndrome patients is challenging in daily clinical practice. Therefore, the question arises whether the clinical outcomes of acute coronary syndrome (ACS) patients with LM disease vary between centers with and without cardiac surgery on site.

Methods: The study is a retrospective analysis of ACS patient outcomes using data from the PL-ACS registry, which is a Polish archive of ACS patients. The following analysis considered patients with LMCAD (n=4000) who were divided into two groups: those treated in the centers with the cardiac surgery department on site (CS group, n=427) and those without (non-CS group, n=3573).

Results: Patients with ACS in non-CS group more often were not qualified for revascularization than patients in CS group (11.7% in the CS group vs. 19.9% in the non-CS group, p<0.001), however, CABG was more common in non-CS group (18.7% in CS group vs. 25.7% in non-CS group, p<0.001). PCI, including angioplasty of LM, was more common in CS-group than non-CS group (38,6% vs. 30,3%, p<0.001). Among patients with ACS in CS group, major adverse cardiac events (MACE) were observed with greater frequency.

Conclusions: Patients with LM disease admitted to the centers with CS initially had more risk factors for more intensive hospitalization compared to patients in centers without CS on-site. Clinical outcomes and treatment procedures may differ regarding the availability of CS on-site.

有和没有现场心脏手术的中心左主干冠状动脉疾病患者急性冠脉综合征的评估数据来自PL-ACS注册表。
背景:急性冠脉综合征患者左主干冠状动脉病变(LMCAD)的治疗在日常临床实践中具有挑战性。因此,问题是急性冠脉综合征(ACS)患者合并LM疾病的临床结果是否会因中心进行和不进行现场心脏手术而有所不同。方法:该研究是对ACS患者结局的回顾性分析,使用来自PL-ACS登记处的数据,这是ACS患者的波兰档案。以下分析考虑LMCAD患者(n=4000),将其分为两组:在有心脏外科现场的中心治疗的患者(CS组,n=427)和没有CS组(非CS组,n=3573)。结果:与CS组相比,非CS组ACS患者更不适合进行血运重建术(CS组为11.7%,非CS组为19.9%)。结论:与没有CS的中心相比,入住CS中心的LM疾病患者最初有更多的危险因素,需要更深入的住院治疗。临床结果和治疗程序可能因现场CS的可用性而有所不同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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