Baseline Clinical and Angiographic Profile of Patients Undergoing Left Main Coronary Artery Percutaneous Intervention in an Indian Tertiary Centre

Abstract

Background Left main coronary artery disease (LM CAD) accounts for 4–9 % of diagnostic angiograms and carries the highest risk among coronary lesions.[1] High quality baseline data from low and middle income settings remain sparse.

Methods We prospectively enrolled 35 consecutive adults (August 2022 – July 2023) undergoing unprotected LM percutaneous coronary intervention (PCI) at Jagjivan Ram Railway Hospital, Mumbai. Detailed demographic, laboratory, echocardiographic and quantitative angiographic variables were captured.

Results Mean age was 66.2 ± 6.3 years; 63 % were male. Hypertension (71 %), diabetes (63 %) and dyslipidaemia (43 %) predominated, with 43 % reporting current smoking. Distal bifurcation involvement occurred in 68 % of cases; 43 % had double vessel and 20 % triple vessel disease in addition to LM stenosis. Median SYNTAX score was 29 (IQR 24–33); IVUS/OCT guidance was used in 100 % of procedures. Left ventricular ejection fraction (LVEF) was preserved (>45 %) in 40 %, moderate (35–45 %) in 31 %, and severely reduced (<35 %) in 20 %.

Conclusion Patients undergoing LM PCI in this single centre Indian cohort were older, burdened with multiple cardiometabolic risk factors and presented predominantly with complex distal bifurcation disease. These data provide a contemporary regional baseline against which procedural strategies and outcomes can be benchmarked.