Ameera Ahmed1, Frank V Aguirre2, Jenny Chambers2, Scott W Sharkey3, Mark A Tannenbaum4, Mehmet Yildiz5, Ross Garberich3, Santiago Garcia3, Timothy D Henry6. 1. Cardiovascular Institute of Northern Colorado, Banner Health, Loveland, USA. 2. Prairie Education and Research Cooperative, Springfield, IL, USA. 3. Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, USA. 4. Iowa Heart Center, West Des Moines, USA. 5. The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, USA. 6. The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH, USA. Tim.Henry@thechristhospital.com.
Abstract
PURPOSE OF REVIEW: There is a paucity of data regarding the prevalence, clinical characteristics, and outcomes of patients presenting with ST elevation myocardial infarction (STEMI) due to left main (LM) culprit vessel. RECENT FINDINGS: LM culprit STEMI (LMCSTEMI) is an uncommon, but frequently catastrophic event. Prior meta-analyses and registries have described a varying prevalence of LMCSTEMI, associated cardiogenic shock, and in-hospital mortality among those surviving to hospital presentation. These observed clinical discrepancies may be partially attributable to diverse clinical and angiographical subsets among this STEMI population. STEMI due to LM culprit artery disease represents a clinically high-risk subset of patients with substantial in-hospital mortality. In this paper, we summarize the available clinical data pertaining to STEMI with LM culprit, discuss unique ECG characteristics, and discuss contemporary revascularization therapy. We also report the preliminary findings from a contemporary, STEMI database describing clinical characteristics and angiographically defined subsets of LM culprit STEMI.
PURPOSE OF REVIEW: There is a paucity of data regarding the prevalence, clinical characteristics, and outcomes of patients presenting with ST elevation myocardial infarction (STEMI) due to left main (LM) culprit vessel. RECENT FINDINGS: LM culprit STEMI (LMCSTEMI) is an uncommon, but frequently catastrophic event. Prior meta-analyses and registries have described a varying prevalence of LMCSTEMI, associated cardiogenic shock, and in-hospital mortality among those surviving to hospital presentation. These observed clinical discrepancies may be partially attributable to diverse clinical and angiographical subsets among this STEMI population. STEMI due to LM culprit artery disease represents a clinically high-risk subset of patients with substantial in-hospital mortality. In this paper, we summarize the available clinical data pertaining to STEMI with LM culprit, discuss unique ECG characteristics, and discuss contemporary revascularization therapy. We also report the preliminary findings from a contemporary, STEMI database describing clinical characteristics and angiographically defined subsets of LM culprit STEMI.
Authors: Gilles Montalescot; David Brieger; Kim A Eagle; Frederick A Anderson; Gordon FitzGerald; Michael S Lee; Ph Gabriel Steg; Alvaro Avezum; Shaun G Goodman; Joel M Gore Journal: Eur Heart J Date: 2009-08-30 Impact factor: 29.983