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Archivos de cardiología de México

versión On-line ISSN 1665-1731versión impresa ISSN 1405-9940


LOPEZ-AGUILAR, Carlos et al. Percutaneous coronary intervention of unprotected left main coronary compared with coronary artery bypass grafting; 3 years of experience in the National Institute of Cardiology, Mexico. Arch. Cardiol. Méx. [online]. 2018, vol.88, n.2, pp.83-92. ISSN 1665-1731.


The best revascularisation method of the unprotected left main artery is a current and evolving topic.


A total of 2439 percutaneous coronary interventions (PCI) were registered during a 3-year period. The study included all the patients with PCI of the unprotected left main coronary (n = 48) and matched with patients who underwent coronary artery bypass graft (CABG) (n = 50). Major adverse cerebral and cardiac events (MACCE) were assessed within the hospital and in outpatients during a 16 month follow up.


The cardiovascular risk was greater in the PCI group; logEuroSCORE 16 ± 21 vs. 5 ± 6, P = .001; clinical Syntax 77 ± 74 vs 53 ± 39, P = .04. On admission, the PCI group of patients had a higher frequency of ST segment elevation myocardial infarction (STEMI) and cardiogenic shock. The MACCE were similar in both groups (14% vs. 18%, P = .64). STEMI was less frequent in the PCI group (0% vs. 10%, P = .03). Cardiovascular events were lower in the PCI group (2.3% vs. 18%, P = .01), and there was a decrease in general and cardiac mortality (2.3% vs. 12%, P = .08 y 2.3% vs. 8%, P = .24), on excluding the patients with cardiogenic shock as a presentation. MACCE were similar in both groups in the out-patient phase (15% vs. 12%, P = .46). Survival without MACCE, general and cardiac death were comparable between groups (log rank, P = .38, P = .44 and P = .16, respectively).


Even though the clinical and periprocedural risk profile of the PCI patients were higher, the in-hospital and out-hospital efficacy and safety were comparable with CABG. © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. This is an open access article under the CC BY-NC-ND license (

Palabras llave : Percutaneous coronary intervention; Unprotected left main coronary artery; Coronary artery bypass grafting; Safety; Efficacy; Mexico.

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