Analysis The Clinical Effect Of Different Intervention Therapy Methods For Unprotected Left Main Coronary Artery Disease

[Objective]In this study,by retrospectively analyzing the advantages and disadvantages of different interventional strategies for unprotected left main coronary artery disease,the incidence of major adverse cardiovascular events in patients with unprotected left main coronary artery disease treated with single stent（Crossover）and double stent（CRUSH,Culotte,and T stent）was statistically analyzed.To evaluate the short-term clinical efficacy of single stent and double stent interventional therapy.[Materials and methods]A total of 156 patients who were admitted to the Department of Cardiology of the Third Affiliated Hospital of Guangzhou Medical University from Januuary 2016 to December 2019 and who underwent coronary angiography showing lesions of the left main artery were selected Tetrospectively.Detailed history,laboratory tests,coronary angiography,oomplications,major adverse cardiovascular events during hospitalization,and 1-year follow-up data were collected for both the single-stent group（Crossover,Culotle,and T-stent group）and the dual-stent group（CRUSH,Culotte,and T-stent）.Retrospectively analyzed the advantages and disadvantages of interventional treatment for unprotected bifurcation of the left main artery with single and dual stents.The primary end points included MACE events durring hospitalization（cardiac death,myocardial infarction,revascularization,stent stenosis,stent thrombosis,etc.）.Secondary endpoints included acute cerebrovascular accident,acute gastrointestinal bleeding,contrast-related renal insufficiency,and cardiac tamponade.The clinical efficacy of different interventional methods in the treatment of unprotected left main coronary artery diisease was evaluated.[Resnlts]1.A total of 156 patients with left main coronary artery disease were included in this study,including119 males(76.28%with an average age of 65.13±11.40 years;There were 36 females（23.72%）with an average age of 67.48±11.46 years.Among them,85 cases（54.49%）used Crossover stent therapy,76.40%male and 23.60%female;there were 71 cases in dual stent group,73.24%male and 26.76%female;In the general clinical data control,the proportion of male patients in the two groups was significantly higher than that of female.2.According to the results of Medina classification,true bifurcation lesions（63 cases）accounted for 88.73%in the dual stent group,38 cases in Medina（1,1,1）,22 cases in Medina（0,1,1）,and 3 cases in Medina（1,0,1）.Medina（1,1,1）was the most common type.In the single stent group,the percentage of false bifurcation lesions was 55.29%,which was more common in Medina（1,1,0）and Medina（0,1,0）,and the difference between the two groups was statistically significant（P<0.05）.In the comparison of SYNTAX sccre groups,the double stent group had a higher SYNTAX score than the single stent group（20.1±4.1 VS 23₅±4.9,P=0.028）,and the proportion of the single stent group was higher（SYNTAX score 0-22 points）（64.71%VS 39.44%）.（SYNTAX SCORE>22）The proportion of dual-stent group was higher（35 29%VS 60 56%）.3.In the occurremce of MACE events,there were 8 cases in the single-stent group and 18 cases in the dual-stent group-The incidence of MACE events in the single-stent group was significantly lower than that in the dual-stent group（9.41%vs 25.35%,P＝0.008）,and the difference was statistically significant.In the events of target vessel revascularization,the dual stent treatment group was significantly higher than the single stent treatment group（4.71%vs 1B.3 1%,P=0.012）,and the difference was statistically significant.4.In the incidence of in-stent thrombosis,the dual-stent strategy was higher than the single-stent strategy（4.71%vs 18.31%,P=0.012）,and the difference was statistically significant.5.In the hierarchical analysis of SYNTAX scare for assessing the extent of lesions,the incidence of MACE events in the single-stent group was lower than that in the dual-stent group（SYNTAX score 0-22）（3.62%vs 21.42%,P=0.028）.There was no statistical significance in the incidence of MACE（SYNTAX score>22）（P>0.05）.6.The stratified analysis of true and false bifurcation lesions in Medina classification showed that there was no statistically significant difference in the occurrence of MACE events between the single stent group and the double stent group in true and false bifucation lesions（P>0.05）..[Couclusions]1.In the group with low SYNTAX score（SYNTAX score 0-22）,single stent was more effective than double stent in the treatment of left main disease.2.For unprotected left main disease,the incidence of in-stent restenosis in patients treated with a single-stent strategy is lower than that of a double-stent strategy.