Prognostic stratification of patients with coronary artery stenosis by presence or absence of left anterior descending artery lesions

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Abstract
Patients with coronary artery disease (CAD) typically develop atherosclerosis proximal to the left anterior descending coronary artery (LAD). However, it is unclear how CAD location affects long-term prognosis in the era of drug-eluting stents. This study compared the clinical profiles and long-term outcomes of patients with and without LAD lesions after percutaneous coronary intervention (PCI). Of 2,497 consecutive patients with CAD who underwent PCI, 1,245 who underwent first-time PCI were enrolled. Baseline profiles and long-term prognoses, including major adverse cardiovascular events (MACE), were compared between patients with de novo CAD localized to the LAD (n=986) and non-LAD lesions (n=259). MACE included cardiovascular death, nonfatal myocardial infarction, and target vessel revascularization. Patients in the LAD group were more likely to be older; had an increased prevalence of diabetes, dyslipidemia, and impaired cardiac and renal function; and had significantly more multi-vessel disease, calcified lesions, and long lesions than the non-LAD group. Kaplan-Meier analysis revealed that the MACE rate was significantly higher in the LAD group (16.6% vs. 5.4%, pGraphical Abstract Prognostic comparisons of in-hospital mortality and MACE after PCI in patients with and without LAD lesions. Comparison of in-hospital mortality and MACE between patients with and without LAD lesions. LAD, left anterior descending artery; MACE, major adverse cardiovascular event; PCI, percutaneous coronary intervention.
Funding Information
  • Saitama Medical University

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