Objective: Acute coronary syndrome (ACS) is associated with adverse outcomes and is a common cause of death. Presence of left main (LM) disease in patients with ACS may increase the rate of morbidity and mortality. The purpose of the present study was to compare short-term outcomes as well as major adverse cardiovascular and cerebrovascular events (MACCE) at 30 days in ACS patients with LM disease treated percutaneously or surgically as com‌pared to those with non-LM disease treated percutaneously. Methods: This is a prospective cross-sectional multicenter study carried out on 100 patients with ACS: Group (I): 50 patients with LM disease, Group (II): 50 patients without LM disease. The LM group was treated percutaneously or surgically and the non-LM group was treated percutaneously. The primary end point is the thirty-day incidence of MACCE.
Results: Patients with LM disease who were treated with percutaneous coronary intervention (PCI) had more frequent repeat revascularization than those with LM disease who were treated with coronary artery bypass graft (CABG) (P=0.022). However, there was no significant statistical difference between LM patients who were treated with PCI and those who were treated with CABG regarding all other 30 days outcomes (P>0.05).
Conclusion: Coronary revascularization of patients with LM disease in the acute setting provided similar outcomes in 30 days when compared to those without LM involvement. ACS patients with LM disease treated with PCI have similar 30 days outcomes in comparison with CABG. However, repeat revascularization was significantly more frequent in LM patients treated with PCI.