- 著者
-
Naoki Shibata
Norio Umemoto
Akihito Tanaka
Kensuke Takagi
Makoto Iwama
Yusuke Uemura
Yosuke Inoue
Yosuke Negishi
Taiki Ohashi
Miho Tanaka
Ruka Yoshida
Kiyokazu Shimizu
Hiroshi Tashiro
Naoki Yoshioka
Itsuro Morishima
Toshiyuki Noda
Masato Watarai
Hiroshi Asano
Toshikazu Tanaka
Yosuke Tatami
Yasunobu Takada
Hideki Ishii
Toyoaki Murohara
on behalf of N-Registry Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-20-0545, (Released:2021-03-20)
- 参考文献数
- 39
- 被引用文献数
-
3
Background:Data regarding the clinical features, outcomes and prognostic factors in patients presenting with acute total/subtotal occlusion of the unprotected left main coronary artery (LMCA) remain limited.Methods and Results:From a multi-center registry, 134 patients due to acute total/subtotal occlusion of the unprotected LMCA were reviewed. Emergency room (ER) status classification was defined according to the presence of cardiogenic shock and cardiopulmonary arrest (CPA) in the ER (class 1=no cardiogenic shock; class 2= cardiogenic shock but not CPA; and class 3=CPA). In-hospital mortality and cerebral performance category (CPC) as the endpoints were evaluated. One-half (67/134) of the enrolled patients presented with total occlusion of the unprotected LMCA. Regarding ER status classification, class 1, 2, and 3 were observed in 30.6%, 45.5%, and 23.9% of the patients, respectively. In-hospital mortality occurred in 73 (54.5%) patients; of the remaining patients, 52 (85.3%) could be discharged with a CPC 1 or 2. ER status classification (odds ratio 4.4 [95% confidence interval: 2.33–10.67]; P<0.001) and total occlusion of the unprotected LMCA (odds ratio 8.29 [95% confidence interval 2.93–23.46]; P<0.001) were strong predictors of in-hospital mortality.Conclusions:Acute total/subtotal occlusion involving the unprotected LMCA appeared to be associated with high in-hospital mortality. ER status classification and initial flow in the unprotected LMCA were significant predictive factors of in-hospital mortality.