Assessment of risk factors and angiographic profile in left main coronary artery disease: An observational study

Background: Diagnostic and management challenges with unpredictable angiographic presentations are encountered in left main coronary artery disease (LMCAD) patients. Therefore, this study was designed to evaluate the prevalence, risk factors, angiographic profile, and outcomes associated with LMCAD at 6-month follow-up. Materials and Methods: This was a prospective observational study where a total of 1474 patients undergoing coronary angiography were enrolled between March 2018 and August 2019. Demographic details, physical examination, and routine biochemical investigations were reported. Obstructive LMCAD patients were managed either with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) according to syntax score, and outcomes were recorded at 6-month follow-up. Results: The mean age of the overall study population (1474 patients) was 59 ± 8.1 years with male 959 (65%) preponderance. Obstructive LMCAD was observed in 103 (6%) patients. Smoking was the prime risk factor associated with obstructive LMCAD observed among 58 (56%) patients followed by hypertension in 45 (43%), dyslipidemia in 42 (40%), obesity in 26 (25%), and diabetes mellitus in 23 (22%) patients. Among 41 (40%) obstructive LMCAD patients, non-ST-elevation myocardial infarction/unstable angina was the major presentation. The majorly affected target vessels were left anterior descending artery (100%) and left circumflex artery (80%) among 103 and 83 patients, respectively. Triple-vessel disease was predominantly observed among 63 (62%) obstructive LMCAD patients. PCI and CABG were performed in 19 (18.4%) and 27 (26.2%) patients with a mean syntax score of 20 and 31, respectively. Conclusion: Smoking, advanced age, diabetes, and dyslipidemia were significantly associated risk factors of LMCAD.