Abstract 1718: Four-Year Outcome of Moderate Left Main Disease: Intravascular Ultrasound Predictor of Events
Background: The long-term outcome of moderate diseased left main (LM) coronary artery remains unknown.
Method: Sixty pts who underwent angiographic and intravascular ultrasound (IVUS) evaluation of moderate LM disease (IVUS minimum lumen area >6.0mm2 in >90% and quantitative angiographic (QCA) diameter stenosis (DS) <50% in 95%) without an intervention were followed for 4 years.
Results: Two pts died of non-cardiac diseases. Of the remaining 58 pts, 5 died of cardiac causes and 1 had bypass surgery; there were no myocardial infarctions. Of the clinical, QCA, and volumetric IVUS parameters, univariate predictors of death or CABG included diabetes; another lesion with DS >50%; mean IVUS vessel area, plaque area, and plaque burden; and calcium-arc >90° (Table⇓). By logistic regression analysis, diabetes (OR=11.00, 95% CI 3.54–34.24, p<0.0001), calcium-arc >90°(OR=17.12, 95%CI; 5.31–55.18, p<0.0001) and IVUS mean plaque burden (OR=0.946, 95%CI; 0.904–0.991, p=0.0193), but not lumen area, were independent predictors of events.
Conclusion: In selected pts evaluated by IVUS, the 4-year event rate of moderate LM disease was only 10.3%. However, in these patients, the predictors of events were diabetes, overall LM plaque burden, and calcification - thereby identifying a high-risk group.