Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study
Abstract Background Obstructive left main disease (LMD) is a challenging entity of coronary artery disease with variable patterns among different studies. We aimed to evaluate the prevalence, demographic, clinical, and angiographic profiles of LMD. We conducted a single-center retrospective study ov...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-02-01
|
| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43044-025-00615-5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823862007194976256 |
|---|---|
| author | Abdulsalam Mahmoud Algamal Mahmoud Abdelbadie Salem Ahmed Ibrahim Bedier Mohammed Salah A. Hussein Mona Malek Abdelrahim Shady Hussein Elhusseiny |
| author_facet | Abdulsalam Mahmoud Algamal Mahmoud Abdelbadie Salem Ahmed Ibrahim Bedier Mohammed Salah A. Hussein Mona Malek Abdelrahim Shady Hussein Elhusseiny |
| author_sort | Abdulsalam Mahmoud Algamal |
| collection | DOAJ |
| description | Abstract Background Obstructive left main disease (LMD) is a challenging entity of coronary artery disease with variable patterns among different studies. We aimed to evaluate the prevalence, demographic, clinical, and angiographic profiles of LMD. We conducted a single-center retrospective study over a period of 10 years to screen all patients who underwent elective cardiac catheterization for chronic coronary syndrome. Of the 19,336 screened cases, 944 obstructive LMD patients were included as the patients' group. Age and sex-matched control groups included patients with normal coronary angiography and non-LMD. Results Obstructive LMD had a prevalence of 4.9%, a mean age of around 60 years, and a male to female ratio of approximately 3:1. About 9.8% of LMD patients were < 50 years. Compared to males, females with LMD had significantly older age and increasing prevalence with age from 9.7% in patients < 50 years to 27.4% in patients > 70 years. LMD versus non-LMD patients had a significantly higher prevalence of diabetes mellitus, dyslipidemia, and number of stenotic coronary segments and arteries, and nonsignificant differences regarding smoking, hypertension, previous myocardial infarction, and ejection fraction. Ostial LMD had a prevalence of 2%, a mean age of around 58 years and 21% were females. In LMD patients, the most affected sites were the ostial/proximal left anterior descending artery and distal left main bifurcation. Bypass grafting surgery was the standard angiographic decision in LMD in 75.8% of cases, which was significantly higher than non-LMD. LMD patients revascularized surgically versus percutaneous treatment had significantly lower ejection fraction, significantly higher multivessel disease, and no significant differences regarding age, sex, hypertension, and diabetes mellitus. Conclusion Obstructive LMD is a relatively common angiographic finding, with a higher prevalence among males around 60 years. In LMD, bypass grafting was the main revascularization strategy. We recommend integrating clinical characteristics, and noninvasive investigations as a predictive model of LMD. |
| format | Article |
| id | doaj-art-daa6d3883506486f94297b10c1a026e5 |
| institution | Kabale University |
| issn | 2090-911X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj-art-daa6d3883506486f94297b10c1a026e52025-02-09T12:43:18ZengSpringerOpenThe Egyptian Heart Journal2090-911X2025-02-0177111010.1186/s43044-025-00615-5Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective studyAbdulsalam Mahmoud Algamal0Mahmoud Abdelbadie Salem1Ahmed Ibrahim Bedier2Mohammed Salah A. Hussein3Mona Malek Abdelrahim4Shady Hussein Elhusseiny5Mansoura UniversityMansoura UniversityMansoura UniversityMansoura UniversityMansoura UniversityMansoura UniversityAbstract Background Obstructive left main disease (LMD) is a challenging entity of coronary artery disease with variable patterns among different studies. We aimed to evaluate the prevalence, demographic, clinical, and angiographic profiles of LMD. We conducted a single-center retrospective study over a period of 10 years to screen all patients who underwent elective cardiac catheterization for chronic coronary syndrome. Of the 19,336 screened cases, 944 obstructive LMD patients were included as the patients' group. Age and sex-matched control groups included patients with normal coronary angiography and non-LMD. Results Obstructive LMD had a prevalence of 4.9%, a mean age of around 60 years, and a male to female ratio of approximately 3:1. About 9.8% of LMD patients were < 50 years. Compared to males, females with LMD had significantly older age and increasing prevalence with age from 9.7% in patients < 50 years to 27.4% in patients > 70 years. LMD versus non-LMD patients had a significantly higher prevalence of diabetes mellitus, dyslipidemia, and number of stenotic coronary segments and arteries, and nonsignificant differences regarding smoking, hypertension, previous myocardial infarction, and ejection fraction. Ostial LMD had a prevalence of 2%, a mean age of around 58 years and 21% were females. In LMD patients, the most affected sites were the ostial/proximal left anterior descending artery and distal left main bifurcation. Bypass grafting surgery was the standard angiographic decision in LMD in 75.8% of cases, which was significantly higher than non-LMD. LMD patients revascularized surgically versus percutaneous treatment had significantly lower ejection fraction, significantly higher multivessel disease, and no significant differences regarding age, sex, hypertension, and diabetes mellitus. Conclusion Obstructive LMD is a relatively common angiographic finding, with a higher prevalence among males around 60 years. In LMD, bypass grafting was the main revascularization strategy. We recommend integrating clinical characteristics, and noninvasive investigations as a predictive model of LMD.https://doi.org/10.1186/s43044-025-00615-5Coronary angiographyCoronary artery bypass graftingCoronary artery diseaseCoronary stenosisLeft main coronary artery diseasePercutaneous coronary intervention |
| spellingShingle | Abdulsalam Mahmoud Algamal Mahmoud Abdelbadie Salem Ahmed Ibrahim Bedier Mohammed Salah A. Hussein Mona Malek Abdelrahim Shady Hussein Elhusseiny Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study The Egyptian Heart Journal Coronary angiography Coronary artery bypass grafting Coronary artery disease Coronary stenosis Left main coronary artery disease Percutaneous coronary intervention |
| title | Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study |
| title_full | Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study |
| title_fullStr | Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study |
| title_full_unstemmed | Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study |
| title_short | Clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome: a retrospective study |
| title_sort | clinical and angiographic profile of left main coronary artery disease in patients with chronic coronary syndrome a retrospective study |
| topic | Coronary angiography Coronary artery bypass grafting Coronary artery disease Coronary stenosis Left main coronary artery disease Percutaneous coronary intervention |
| url | https://doi.org/10.1186/s43044-025-00615-5 |
| work_keys_str_mv | AT abdulsalammahmoudalgamal clinicalandangiographicprofileofleftmaincoronaryarterydiseaseinpatientswithchroniccoronarysyndromearetrospectivestudy AT mahmoudabdelbadiesalem clinicalandangiographicprofileofleftmaincoronaryarterydiseaseinpatientswithchroniccoronarysyndromearetrospectivestudy AT ahmedibrahimbedier clinicalandangiographicprofileofleftmaincoronaryarterydiseaseinpatientswithchroniccoronarysyndromearetrospectivestudy AT mohammedsalahahussein clinicalandangiographicprofileofleftmaincoronaryarterydiseaseinpatientswithchroniccoronarysyndromearetrospectivestudy AT monamalekabdelrahim clinicalandangiographicprofileofleftmaincoronaryarterydiseaseinpatientswithchroniccoronarysyndromearetrospectivestudy AT shadyhusseinelhusseiny clinicalandangiographicprofileofleftmaincoronaryarterydiseaseinpatientswithchroniccoronarysyndromearetrospectivestudy |