Clinical analysis of percutaneous coronary intervention for treating the patients with acute myocardial infarction caused by sudden total occlusion of left main coronary artery / 中国介入心脏病学杂志

ABSTRACT

Objective To explore the clinical features of acute myocardial infarction(AMI) caused by left main coronary artery(LMCA)sudden total occlusion and to investigate the clinical efficacy of percutaneous coronary intervention(PCI). Methods A retrospective analysis was carried out and patients with AMI due to LMCA sudden occlusion proved by emergency coronary angiography in General Hospital of DaQing Oil Field between 2000 and 2016 were included. The patients were divided into the survival group and the deceased group. The clinical condition during hospitalization were compared. All in survived cases were followed up by telephone or at out-patient clinic. Results Among 1281 emergency coronary angiography cases,15 patients were proved to have LMCA sudden occlusion and 13 of them received PCI. 6 patients died during hospitalization and the in-hospital mortality rate was 46.2％(6/13). Among the 9 patients who received direct PCI ,5 of them died(55.6％);while 4 patients had elective PCI ,1 patient of them died(25％). Three out of the 4 patients who presented TIMI grade 3 flow died. Among the 9 patients who had TIMI grade 1～2 flow,3 patients died. Eight patients received deal anti-platelet therapy with clopidogrel and aspirin after PCI,and among them,4 patients died. Among the 5 given ticagrelor,2 patients died. During the follow-up period. 1 patient died of cardiogenic shock,2 patients had recurrent angina and 1 patient required elective PCI to the RCA. Conclusions The morality of LMCA sudden total occlusion was significantly high. Successful PCI may be feasible to these patients,while the major adverse cardiovascular events(MACE)occurrence during long-term follow-up period remained high.