Influence of left main-left circumflex artery angle on long-term outcomes in crossover stenting for ostial left circumflex artery lesions: insights from the Multicenter CROSS-LCX Registry.

IF 2.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2026-09-01 Epub Date: 2026-03-17 DOI:10.1097/MCA.0000000000001631

Ezgi Gültekin Güner, Ebru Serin, Muhammed Furkan Deniz, Sezer Markirt, Mehmet Erdoğan, Kurtuluş Karaüzüm, Semih Kalkan, Ali Nazmi Çalik, Serkan Asil, Veysel Ozan Tanik, Ahmet Anil Başkurt, Fatih Levent, Faruk Kara, Enes Arslan, Cemalettin Akman, Ahmet Yaşar Çizgici, Özge Çebi, Uygar Çağdaş Yüksel, İbrahim Faruk Aktürk, Kudret Keskin, İrfan Şahin, Ahmet Güner, Fatih Uzun

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引用次数: 0

Abstract

Background: The influence of left main bifurcation angles on cardiovascular outcomes following crossover stent implantation (CSI) in patients with ostial left circumflex artery (LCX) lesions has not been well established. This investigation sought to determine the relationship between left main bifurcation angles and poor cardiovascular outcomes in patients who underwent CSI of ostial LCX lesions.

Methods: This large-scale, multicenter ( n = 14) observational, retrospective study included 267 patients [men: 192 (71.9%), mean age: 66.30 ± 10.93 years] who underwent percutaneous coronary intervention with CSI for ostial LCX lesions. The primary outcome was major adverse cardiac events (MACE), including cardiac death, target vessel revascularization, and target vessel myocardial infarction. Patients were categorized into two groups as MACE (+) and MACE (-).

Results: At least one MACE occurred in 49 patients (18.3%) in the study cohort. The left main-LCX angle (108.44 ± 17.93° vs. 115.89 ± 14.760°, P = 0.041) was significantly lower in the MACE (+) group compared to the MACE (-) group. In multivariate Cox regression analysis, increased left main-LCX angle was identified as one of the independent predictors of MACE (hazard ratios: 0.968, P = 0.005). In the receiver operating characteristic curve analysis, a left main-LCX angle lower than 99° predicted the presence of MACE with a sensitivity of 64% and a specificity of 75% (area under the curve: 0.721, 95% confidence interval: 0.663-0.774, P < 0.001). The prevalence of MACE was notably higher in patients with left main-LCX angle <99° as compared to others (53.3 vs. 11.3%, P < 0.001).

Conclusions: This multicenter study shows that a narrow left main-LCX angle (99°) value may be associated with poor cardiovascular events in patients who underwent CSI for ostial LCX disease.

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左主-左旋动脉角度对交叉支架术治疗口侧左旋动脉病变长期疗效的影响：来自多中心CROSS-LCX注册的见解。

背景：左主干分叉角度对开口左旋动脉病变患者交叉支架植入术（CSI）后心血管结局的影响尚未得到很好的证实。本研究旨在确定左主干分叉角度与接受口LCX病变CSI患者不良心血管预后之间的关系。方法：这项大规模、多中心（n = 14）观察性、回顾性研究纳入267例患者[男性：192例（71.9%），平均年龄：66.30±10.93岁]，接受经皮冠状动脉介入治疗。主要终点是主要心脏不良事件（MACE），包括心源性死亡、靶血管血运重建和靶血管心肌梗死。将患者分为MACE（+）组和MACE（-）组。结果：研究队列中49例（18.3%）患者至少发生一次MACE。MACE（+）组左主- lcx角度（108.44±17.93°vs 115.89±14.760°，P = 0.041）明显低于MACE（-）组。在多变量Cox回归分析中，左主- lcx角增加被确定为MACE的独立预测因子之一（风险比：0.968,P = 0.005）。在受试者工作特征曲线分析中，左主-LCX角度小于99°预测MACE的存在，敏感性为64%，特异性为75%（曲线下面积：0.721,95%可信区间：0.663-0.774，P）。结论：本多中心研究显示，左主-LCX角度（99°）窄可能与因口部LCX疾病行CSI的患者心血管事件不良相关。

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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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.