Abstract Summary
This 5-year longitudinal registry study evaluates long-term clinical safety, major adverse cardiac events (MACE), and stent thrombosis rates in 420 patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) lesions using second-generation drug-eluting stents (DES) in Bangladesh.
Article Description & Overview
BACKGROUND & OBJECTIVES:
Left main coronary artery (LMCA) disease represents the highest-risk anatomical subset in interventional cardiology. Historically treated exclusively with Coronary Artery Bypass Grafting (CABG), percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has emerged as a viable alternative for patients with low to intermediate SYNTAX scores.
METHODS & REGISTRY DESIGN:
A prospective, multi-center observational registry conducted across tertiary cardiac centers in Dhaka from January 2021 to December 2025. A total of 420 consecutive patients undergoing PCI for unprotected left main stenosis were enrolled. Primary endpoints included 5-year All-Cause Mortality, Cardiac Death, Target Lesion Revascularization (TLR), and Stent Thrombosis (ST).
RESULTS:
The 5-year cumulative MACE rate was 8.4%. Target lesion revascularization occurred in 3.2% of patients. Intracoronary imaging guidance (IVUS/OCT) was utilized in 68% of procedures and was associated with a statistically significant reduction in 5-year TLR (2.1% vs 5.6%, p=0.02).
CONCLUSION:
PCI for unprotected left main coronary disease utilizing second-generation DES and routine intravascular imaging guidance yields highly favorable 5-year clinical outcomes with acceptable long-term safety profiles.
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