Examination of demographic, clinical and angiographic characteristics of patients with left main coronary artery lesion and evaluation of their prognosis

Aim: Left main coronary artery (LMCA) disease is a challenging atherosclerotic disease with high morbidity and mortality. Therefore, we aimed to analyze the demographic, clinical and angiographic characteristics and prognosis of patients with LMCA disease. Methods: The study included 647 patients with LMCA lesions who underwent coronary angiography at Karadeniz Technical University Farabi Hospital between 2018 and 2022. Patients were retrospectively screened and divided into two groups according to lesion severity. Patients with LMCA stenosis below 50% were classified as non-critical and LMCA stenosis 50% and above were classified as critical. Patients were compared in terms of demographic, clinical and angiographic lesion characteristics and one-year prognosis. Results: The mean age of the patients was 68.2±10.6 years and 82.4% were male. Critical stenosis of the LMCA was observed in 36.6% of the patients. A history of chronic kidney disease (CKD) and ischemic stroke was more common in the critical stenosis group (p=0.008, p=0.023, respectively). ECG findings of ≥1 mm ST segment elevation in aVR/V1 or ≥1 mm ST segment depression in V4-6 were more common in patients with critical LMCA stenosis (p<0.001). LMCA diameter and length were found to be higher in the group with non-critical LMCA stenosis (p<0.001, p=0.006, respectively) but the bifurcation angle was similar. At one-year follow-up of patients, more fatalities were seen in the group with critical LMCA stenosis (p=0.023). Patients who died had a lower ejection fraction and a higher mean SYNTAX I score. Conclusion: Patients' history of CKD and ischemic stroke, narrow LMCA diameter and short LMCA length affect lesion severity. Critical LMCA stenosis, low EF and high SYNTAX I score negatively affect the prognosis. Keywords: Left main coronary artery, coronary angiography, SYNTAX, prognosis