The following is a summary of “Impact of polyvascular disease in patients undergoing unprotected left main percutaneous coronary intervention,” published in the April 2024 issue of Cardiology by Bay et al.

Percutaneous coronary intervention (PCI) is a well-established treatment for left main (LM) coronary artery disease (LM-CAD) in specific patients. However, patients with polyvascular disease (PolyVD), which involves both coronary and other vascular diseases, often face significant complications with coronary artery disease (CAD). 

Researchers conducted a retrospective study determining the effects of PolyVD on patients undergoing PCI for LM-CAD. 

They used studies that included patients undergoing PCI for left main disease (LM-PCI) at a single tertiary center between 2012 and 2019. Patients were divided into two groups: those with PolyVD and those without while also looking for LM-CAD. The follow-up period was over one year after index PCI, combining things like mortality and heart attacks into a measure called major adverse cardiovascular events (MACE). 

The results showed that out of 869 patients included in the study, 23.8% of them had PolyVD. Those with PolyVD were generally older, with a more significant burden of comorbidities. This group also had significantly higher rates of MACE after one year (22.8% vs. 9.4%, P<0.001) and more bleeding compared to those without PolyVD. The higher risk of MACE was mainly due to an increase in all-cause mortality (18.3% vs. 7.1%, P<0.001). 

Investigators concluded that having PolyVD was associated with a higher risk of MACE events and bleeding after one year for patients who underwent PCI for LM-CAD, signifying a need for careful attention during and after PCI initiation. 

Source: ajconline.org/article/S0002-9149(24)00317-5/abstract#%20