Clinical and Angiographic findings in patients with significant left main coronary artery stenosis

Abstract

Objective: To evaluate the clinical and angiographic features of patients with significant (>50%) left main coronary artery (LMCA) stenosis. Study design & settings: In this prospective descriptive study, we evaluated clinical and angiographic features of 100 consecutive patients with significant LMCA stenosis, which were selected from 1284 patients undergoing coronary angiography at Punjab Institute of Cardiology, Lahore. Results: Significant LMCA stenosis was seen in 7.7% patients. There were 83 males (83%) and 17 females (17%). Age of the patients ranged from 35 to 72 with mean age of male patients 55.84 ± 9.99 years and that of female patients 54.12 ± 9.89 years. Severe angina (NYHA class III-IV) was the most common finding. 54% of the patients had ST depression in resting ECG while ECG was found to be normal in 19 (19%) patients. Hypercholesterolemia was the most commonly found risk factor. 94% patients had disease in other coronary arteries and left anterior descending artery (LAD) was the most commonly involved vessel. Majority of the patients (>70%) had preserved left ventricular (LV) systolic function. All patients underwent coronary angiography safely without any serious complication. Conclusions: Among patients undergoing routine coronary angiography about 8% had significant LMCA stenosis. Most of these had disease in other coronary arteries, especially in males. Severe angina along with diffuse ST depression in multiple ECG leads and strongly positive exercise test were common findings in patients with LMCA stenosis However no specific clinical features were found which could distinguish the patients with LMCA stenosis from other patients with coronary artery disease (CAD).