Study Of Clinical Therapies On Left Main Coronary Artery Stenosis

Objective To observe on the clinical characteristics of left main coronary artery stenosis and compare the effect of three clinical therapies including pure drug therapy, PCI and CABG.Methods From January 2004 to June 2006,a total of 72 left main coronary artery stenosis patients were admitted to the Department of Cardiology in Shangdong Provincial Hospital. The clinical and CAG information were collected and studied. The follow-up was carried out from November to December in 2006, and the major adverse cardiac events including death, MI and revascularization was observed.Results (1) Comparison of clinical data :The rate of angina was 83.3%, no obvious difference was observed in the four groups. The rate of MI was 59.7% , There was obvious difference in three-vessel stenosis LM group and the other groups. The LVEF in isolated LM group was obviously high than two-vessel stenosis LM group and three-vessel stenosis LM group. (2) Isolated LM group had 6 patients(8.3 %), one-vessel stenosis LM group 6 patients(8.3%), two-vessel stenosis LM group 11patients(15.3% )and three-vessel stenosis LM group 49 patients(68.1 %). Class I LM stenosis group had 32 patients(44.4%), Class II LM stenosis group 21 patients(29.2%), Class III LM stenosis group 18 patients(25%) and totol occlusion 1 patient.(3) No significance was concluded about the recent effect among this three different therapies; At long term, the rate of death and MI was lower in revascularization group than pure drug therapy group. The rate of revascularization was not different in PCI and pure drug therapy groups, but CABG group was lower. The rate of angina recurrence was lower in the groups of PCI and CABG than in the group of medicine therapy.Conclusions Stenting for selected patients with unprotected LMCA stenosis is feasible and safe and had good recent and long term effects. Revascularization can prolong life and reduce MACE in the long term.