<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction:</bold> The location of culprit lesions on the left main is associated with an increased procedural risk in acute coronary syndromes. Our study aims to evaluate the utility of CT angiography determined Syntax score (CCTA) in comparison with the classical angiographic Syntax score for predicting the procedural success in percutaneous coronary interventions (PCI) of left main lesions.<bold>Methods:</bold> We included 23 patients presenting to the Cardiology Clinic with an acute coronary syndrome. All patients underwent coronary angiography ± angio CT multisclice for assessment of the target lesion, defined as a significant (>50%) left main disease. Patient population consisted in: group 1 – 13 patients (56.52%), in whom revascularization indication was based on lesion severity assessment by CCTA score correlated with the angio Syntax score (SS), and group 2 – 10 patients (43.48%), in whom revascularization indication was based only on angio SS. According to the SS, the study population was divided into subgroup A – low SS (&lt;22), subgroup B – intermediate SS (23–32) and subgroup C –high SS (>32). All patients were followed for 1 year.<bold>Results:</bold> Despite similar SS in both groups (35.38 in group 1 vs. 32.4 in group 2), the use of Angio CT multislice increased the rate of PCI indication – 76.92% PCI in group 1 versus 50% PCI in group 2. In patients with high SS, PCI rate was 66.66% in group 1 compared with 50% in group 2 (p&lt;0.05). High calcium score >100 was recorded in 50% of patients in the low SS subgroup (&lt;22), 50% in the medium SS subgroup (23–32) and 22.22% in the high SS (>33) subgroup. One-year follow-up showed an overall mortality of 8.69%, slightly higher in group 2 (10%), as compared to group 1 (mortality of 7.69%).<bold>Conclusions:</bold> Additional evaluation by angio CT of culprit left main stenoses in acute coronary syndromes provides more information about the complexity of atherosclerotic plaques in this location, and could be extremely useful in establishing the indication for PCI in high risk stenoses, showing a predictive significance for post-procedural 1 year follow up mortality.</abstract>

Introduction: The location of culprit lesions on the left main is associated with an increased procedural risk in acute coronary syndromes. Our study aims to evaluate the utility of CT angiography determined Syntax score (CCTA) in comparison with the classical angiographic Syntax score for predicting the procedural success in percutaneous coronary interventions (PCI) of left main lesions.Methods: We included 23 patients presenting to the Cardiology Clinic with an acute coronary syndrome. All patients underwent coronary angiography ± angio CT multisclice for assessment of the target lesion, defined as a significant (>50%) left main disease. Patient population consisted in: group 1 – 13 patients (56.52%), in whom revascularization indication was based on lesion severity assessment by CCTA score correlated with the angio Syntax score (SS), and group 2 – 10 patients (43.48%), in whom revascularization indication was based only on angio SS. According to the SS, the study population was divided into subgroup A – low SS (<22), subgroup B – intermediate SS (23–32) and subgroup C –high SS (>32). All patients were followed for 1 year.Results: Despite similar SS in both groups (35.38 in group 1 vs. 32.4 in group 2), the use of Angio CT multislice increased the rate of PCI indication – 76.92% PCI in group 1 versus 50% PCI in group 2. In patients with high SS, PCI rate was 66.66% in group 1 compared with 50% in group 2 (p<0.05). High calcium score >100 was recorded in 50% of patients in the low SS subgroup (<22), 50% in the medium SS subgroup (23–32) and 22.22% in the high SS (>33) subgroup. One-year follow-up showed an overall mortality of 8.69%, slightly higher in group 2 (10%), as compared to group 1 (mortality of 7.69%).Conclusions: Additional evaluation by angio CT of culprit left main stenoses in acute coronary syndromes provides more information about the complexity of atherosclerotic plaques in this location, and could be extremely useful in establishing the indication for PCI in high risk stenoses, showing a predictive significance for post-procedural 1 year follow up mortality.

The Value of Angio CT Multislice for Pre-operative Assessment and Prediction of Post PCI Successful Intervention in Acute Coronary Syndromes Associated by Left Main Disease

University of Medicine and Pharmacy of Tîrgu Mureș, Clinic of Cardiology, Tîrgu Mureș, Romania

Cardio Med Medical Center, Department of Advanced Multimodal Imaging, Tîrgu Mureș, Romania

Journal of Cardiovascular Emergencies

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction: The location of culprit lesions on the left main is associated with an increased procedural risk in acute coronary syndromes. Our study aims to evaluate the utility of CT angiography determined Syntax score (CCTA) in comparison with the classical angiographic Syntax score for predicting the procedural success in percutaneous coronary interventions (PCI) of left main lesions.Methods: We included 23 patients presenting to the Cardiology Clinic with an acute coronary syndrome. All patients underwent coronary angiography ± angio CT multisclice for assessment of the target lesion, defined as a significant (>50%) left main disease. Patient population consisted in: group 1 – 13 patients (56.52%), in whom revascularization indication was based on lesion severity assessment by CCTA score correlated with the angio Syntax score (SS), and group 2 – 10 patients (43.48%), in whom revascularization indication was based only on angio SS. According to the SS, the study population was divided into subgroup A – low SS (32). All patients were followed for 1 year.Results: Despite similar SS in both groups (35.38 in group 1 vs. 32.4 in group 2), the use of Angio CT multislice increased the rate of PCI indication – 76.92% PCI in group 1 versus 50% PCI in group 2. In patients with high SS, PCI rate was 66.66% in group 1 compared with 50% in group 2 (p100 was recorded in 50% of patients in the low SS subgroup (33) subgroup. One-year follow-up showed an overall mortality of 8.69%, slightly higher in group 2 (10%), as compared to group 1 (mortality of 7.69%).Conclusions: Additional evaluation by angio CT of culprit left main stenoses in acute coronary syndromes provides more information about the complexity of atherosclerotic plaques in this location, and could be extremely useful in establishing the indication for PCI in high risk stenoses, showing a predictive significance for post-procedural 1 year follow up mortality.

Introduction: The location of culprit lesions on the left main is associated with an increased procedural risk in acute coronary syndromes. Our study aims to...

The Value of Angio CT Multislice for Pre-operative Assessment and Prediction of Post PCI Successful Intervention in Acute Coronary Syndromes Associated by Left Main Disease

Published Online: Nov 07, 2015

Page range: 29 - 34

DOI: https://doi.org/10.1515/jce-2015-0005

Keywords
left main, stenting, angioplasty, acute coronary syndromes

© 2015 Ciprian Blendea et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The Value of Angio CT Multislice for Pre-operative Assessment and Prediction of Post PCI Successful Intervention in Acute Coronary Syndromes Associated by Left Main Disease

Published Online: Nov 07, 2015

Page range: 29 - 34

DOI: https://doi.org/10.1515/jce-2015-0005

Keywordsleft main, stenting, angioplasty, acute coronary syndromes

© 2015 Ciprian Blendea et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
left main, stenting, angioplasty, acute coronary syndromes