Abstract 16239: Association Between Coronary Arterial Dominance and Mortality in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
Introduction: Left or co-dominant coronary arterial circulation may provide less favorable myocardial perfusion compared to a right dominant system, resulting in increased short- and long- term mortality in acute coronary syndrome (ACS).
Objectives: We sought to study whether left or co-dominance versus right conferred worse in-hospital, 30 day, and 1 year mortality after percutaneous coronary intervention (PCI) for ACS.
Methods: Using the Massachussets Data Analysis Center database, we studied 14,499 persons with ACS undergoing PCI between April 1, 2003 and December 31, 2004 in all the acute care, non-Federal hospitals in Massachusetts. Coronary dominance was determined by PCI operator. Logistic regression analysis was performed in unadjusted and multivariable adjusted models. Covariates included age, gender, race, ACS event, hypertension, dyslipidemia, and obesity.
Results: Having either left or co-dominant circulation vs. right was associated with increased in-hospital, 30-day, and 1-year mortality (Table). Compared with right dominance, left dominance was associated with similarly worsened outcomes, while co-dominance was associated with increased 1-year mortality without greater short term mortality.
Conclusion: Having either left or co-dominant vs. right dominant coronary circulation is associated with increased in-hospital, 30-day, and 1-year mortality in patients undergoing PCI for ACS. Coronary dominance may be important to consider in the risk stratification of patients with ACS undergoing PCI.
- Acute coronary syndromes
- Percutaneous coronary intervention
- Coronary artery disease
- © 2012 by American Heart Association, Inc.