ORIGINAL ARTICLES   

Minerva Cardioangiologica 2009 April;57(2):175-83

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Prevalence of left main coronary artery disease among patients with ischemic heart disease: insights from the Tehran Angiography Registry

Soleimani A., Abbasi A., Kazzazi E. H., Hosseini K., Salirifar M., Darabian S., Sadeghian S., Sheikhfathol-lahi M.

Department of Research, Cardiology Tehran Heart Center Tehran University of Medical Sciences, Tehran, Iran

Aim. This study was designed to investigate the prevalence of left main coronary artery (LMCA) significant stenosis among patients with stable angina (SA) or acute coronary syndromes (ACSs) and to assess the influence of demographic and clinical profiles on these findings.
Methods. A review of the Angiography Registry demonstrated that 18 137 patients had SA or ACSs. The patients' characteristics were compared in subgroups with and without LMCA disease.
Results. Significant and minimal LMCA stenoses were found in 659 (3.6%) and 1 157 (6.4%) patients, respectively. An unprotected LMCA disease was estimated in 609 (3.4%) subjects. A cumulative Logit Model analysis revealed the male gender (odds ratio [OR]=1.480, 95% confidence interval [CI]=1.287 to 1.703; P<0.001), diabetes mellitus (OR=1.158, 95% CI=1.029 to 1.303; P=0.015), dyslipidemia (OR=1.125, 95% CI=1.001 to 1.265; P=0.048), and aging (OR=1.028, 95% CI=1.022 to 1.034; P<0.001) as the independent predictors of LMCA stenosis with coexistent diseases in the rest of the coronary arteries. In the patients with normal or minimal stenoses of the other coronary arteries, cigarette smoking (OR=3.749, 95% CI=1.698 to 8.070) was found to be the independent risk factor of isolated LMCA disease. Luminal stenosis >50% in the right coronary artery, the left circumflex artery, and the left anterior descending artery was significantly more frequent in association with LMCA disease.
Conclusion. The patients with LMCA disease were more likely to be male, older, and have diabetes mellitus or dyslipidemia, whereas cigarette smoking was found as an independent predictor of isolated LMCA. There was a strong correlation between the severity of LMCA stenosis and coexistent diseases in the rest of the coronary arteries.