A158

JACC April 1, 2014

Volume 63, Issue 12

Acute Coronary Syndromes

Left Main Coronary Artery ST-Elevation Myocardial Infarction: Clinical Characteristics
and Outcomes from a Multicenter Registry

Poster Contributions
Hall C
Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.

Session Title: Acute Coronary Syndromes: STEMI

Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1190-243

Authors: Khung Keong Yeo, Gagan Singh, Kelvin Chua, Jonathan Yap, Ehrin Armstrong, Stephen W. Waldo, Krishan Soni, Gregory Barsness, Jamie
McCabe, Ehtisham Mahmud, David Muller, Jason Rogers, Aaron Wong, Kendrick Shunk, UC Davis Medical Center, Sacramento, CA, USA, National
Heart Centre Singapore, Singapore, Singapore

Background: ST-elevation myocardial infarction (STEMI) involving the left main coronary artery (LMCA) has been associated with significant
morbidity and mortality. Most studies are limited by small sample sizes. The aim of this study is to describe the clinical characteristics and outcomes
in patients with LM STEMI in a large contemporary cohort.

Methods: Patients who presented with LM-STEMI or its equivalent from 3 tertiary referral centers from May 2003 to December 2011 were
included. LM-STEMI was defined as STEMI secondary to a culprit LMCA stenosis of ≥80% or acute thrombosis based on angiography. LMCA STEMI
equivalent was defined as cardiogenic shock, ventricular tachycardia/fibrillation (VT/VF) or sudden cardiac arrest due to a culprit lesion in the
LMCA. Patients with a non-culprit LMCA stenosis or prior coronary artery bypass grafting (CABG) were excluded.

Results: 74 patients were included. 67 (91%) patients presented with STEMI on ECG while 7 presented with VT/VF. Table 1 summarizes the
patients’ clinical characteristics. The average length of hospital stay was 11.3 ± 11.4 days. In-hospital mortality was 39.2% (n=29). On multivariate
analyses, significant predictors of mortality included older age (OR 1.07, 95% CI 1.03-1.12, p=0.002) and presentation with cardiogenic shock (OR
7.3, 95% CI 1.9-28.2, p=0.004).

Conclusions: In-hospital mortality in our patients who presented with LM STEMI was 39.2%. Significant predictors of mortality include older age
and cardiogenic shock.