Coronary artery disease
Prevalence of Narrowing ≥50% of the Left Main Coronary Artery Among 17,300 Patients Having Coronary Angiography

https://doi.org/10.1016/j.amjcard.2006.05.052Get rights and content

We sought to investigate the prevalence of left main coronary artery significant stenosis (LMSS) (≥50% of the luminal diameter) in an angiographic series of patients, to describe the associated coronary stenoses, and to assess the influence of age and gender on these findings. The angiograms of 17,323 consecutive patients from January 1, 1984 to December 31, 2003 were retrospectively analyzed. LMSS was found in 823 patients (4.8%) and was more predominant in men (p <0.001). Men with LMSS (median age 63 years, interquartile range 57 to 69) were younger than the women (median age 67 years, interquartile range 61 to 72, p <0.001). Logistic regression analyses revealed male gender (odds ratio [OR] 1.79, 95% confidence interval [CI] 1.46 to 2.18, p <0.001) and age (OR 1.05, 95% CI 1.04 to 1.06, p <0.001) as independent predictors of LMSS. In the total series, luminal narrowing ≥50% in the right coronary artery, the left circumflex artery, the left anterior descending artery, the intermediate artery, first and second obtuse marginal branch, posterior descending artery, and posterolateral branch was significantly more frequent in association with LMSS. Approximately half of the patients with LMSS also had triple-vessel disease. Co-existent disease in 3 major vessels with minor branches was more evident in men (men/women OR 1.77, 95% CI 1.08 to 2.88, p = 0.02). In contrast, the remaining 4.7% of patients with LMSS, and this was more frequent in women (men/women OR 0.31, 95% CI 0.15 to 0.61, p = 0.001). In conclusion, men presented more frequently with LMSS and at a younger age than women. Also, LMSS with co-existent triple-vessel disease was more common in men.

Section snippets

Methods and Results

The data of 17,323 consecutive patients who underwent coronary angiography for any reason at our institution in Northern Greece from January 1, 1984 to December 31, 2003 were assessed through our database and retrospectively analyzed. The demographic parameters, in particular age and gender, of the investigated patients were recorded and summarized. All the angiograms were evaluated by an independent, expert interventional cardiologist blinded to the patients’ clinical and laboratory data. The

Discussion

The large number of patients included in our study (n = 17,323) enabled us to come to a secure and solid estimation regarding the prevalence of LMSS in the studied population. The prevalence of LMSS in our series (n = 823, 4.8%) was within the range of prevalence rates reported in previous studies.1, 2, 3, 4, 5 Several studies in the past6, 7 reported the absence of a substantial gender difference in the prevalence of LMSS in patients with angiographically significant coronary disease, although

References (16)

There are more references available in the full text version of this article.

Cited by (77)

  • Predicting left main stenosis in stable ischemic heart disease using logistic regression and boosted trees

    2023, American Heart Journal
    Citation Excerpt :

    Only a small number of studies have focused specifically on left main disease prediction among patients with stable ischemic heart disease. A study with more than 17,000 patients undergoing coronary angiography in Greece has found that those with significant left main coronary artery disease were more likely to be male and older compared to patients without left main disease.23 Recently, the ISCHEMIA investigators reported a clinical prediction model of left main coronary artery disease using CCTA as the gold standard among 5,146 patients, mainly with moderate or severe ischemia.7

  • Sex Differences in Clinical Outcomes Following Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery: A Systematic Review and Meta-Analysis

    2021, Cardiovascular Revascularization Medicine
    Citation Excerpt :

    Based on 2016 estimates, 6.7% of Americans ≥20 years of age have CHD which approximates to around 18 million [1]. Significant left main coronary disease (LMCD), defined as left main (LM) coronary artery narrowing of ≥50% on coronary angiography, is noted in 3–7% of patients undergoing coronary angiography and is associated with higher rates of clinical events [2,3]. Despite the lower overall prevalence of LMCD in women, isolated LMCD is more frequent in women compared to men [3].

  • Intravascular ultrasound guidance in the evaluation and treatment of left main coronary artery disease

    2021, International Journal of Cardiology
    Citation Excerpt :

    Atherosclerotic obstruction of the left main coronary artery (LMCA) is present in approximately 4% of all coronary angiograms [1].

View all citing articles on Scopus

This study was supported by a grant from the Greek State Scholarships Foundation, Athens, Greece.

View full text