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Left Main Coronary Artery Stenosis

MedGen UID:
412158
•Concept ID:
C2062905
•
Disease or Syndrome

Definition

Percent luminal narrowing of the left main coronary artery, at the point of maximal stenosis of the left main coronary artery. [from NCI]

Professional guidelines

PubMed

Left main coronary artery disease: pathophysiology, diagnosis, and treatment.
Collet C, Capodanno D, Onuma Y, Banning A, Stone GW, Taggart DP, Sabik J, Serruys PW
Nat Rev Cardiol 2018 Jun;15(6):321-331. doi: 10.1038/s41569-018-0001-4. PMID: 29599504
Left main coronary artery stenosis: severity evaluation and implications for management.
Habibi SE, Shah R, Berzingi CO, Melchior R, Sumption KF, Jovin IS
Expert Rev Cardiovasc Ther 2017 Mar;15(3):157-163. Epub 2017 Feb 24 doi: 10.1080/14779072.2017.1294065. PMID: 28256180
Treatment of unprotected left main coronary artery stenosis in the drug-eluting stent era.
Tanigawa J, Sutaria N, Goktekin O, Di Mario C
J Interv Cardiol 2005 Dec;18(6):455-65. doi: 10.1111/j.1540-8183.2005.00086.x. PMID: 16336426

Recent clinical studies

Etiology

Evolution of our understanding of the aVR sign.
Gibbs MA, Leedekerken JB, Littmann L
J Electrocardiol 2019 Sep-Oct;56:121-124. Epub 2019 Aug 1 doi: 10.1016/j.jelectrocard.2019.07.014. PMID: 31401390
Left main coronary artery disease: pathophysiology, diagnosis, and treatment.
Collet C, Capodanno D, Onuma Y, Banning A, Stone GW, Taggart DP, Sabik J, Serruys PW
Nat Rev Cardiol 2018 Jun;15(6):321-331. doi: 10.1038/s41569-018-0001-4. PMID: 29599504
Percutaneous coronary intervention versus coronary artery bypass grafting: where are we after NOBLE and EXCEL?
Fortier JH, Shaw RE, Glineur D, Grau JB
Curr Opin Cardiol 2017 Nov;32(6):699-706. doi: 10.1097/HCO.0000000000000450. PMID: 28786862
Exploring coronary atherosclerosis with intravascular imaging.
Puri R, Tuzcu EM, Nissen SE, Nicholls SJ
Int J Cardiol 2013 Sep 30;168(2):670-9. Epub 2013 Apr 7 doi: 10.1016/j.ijcard.2013.03.024. PMID: 23571162
Left main coronary artery stenosis: state-of-the-art.
El-Menyar AA, Al Suwaidi J, Holmes DR Jr
Curr Probl Cardiol 2007 Mar;32(3):103-93. doi: 10.1016/j.cpcardiol.2006.12.002. PMID: 17382834

Diagnosis

Assessment of left main coronary artery disease: a comparison between invasive and noninvasive.
Alalawi LH, Dookhan CM, Verghese D, Manubolu VS, Aldana-Bitar J, Lakshmanan S, Ahmad K, Shafter A, Alchokhachi Z, Ghanem A, Golub IS, Budoff M, Roy S
Coron Artery Dis 2022 Sep 1;33(6):490-498. Epub 2022 Jun 22 doi: 10.1097/MCA.0000000000001154. PMID: 35757932
Evolution of our understanding of the aVR sign.
Gibbs MA, Leedekerken JB, Littmann L
J Electrocardiol 2019 Sep-Oct;56:121-124. Epub 2019 Aug 1 doi: 10.1016/j.jelectrocard.2019.07.014. PMID: 31401390
Left main coronary artery disease: pathophysiology, diagnosis, and treatment.
Collet C, Capodanno D, Onuma Y, Banning A, Stone GW, Taggart DP, Sabik J, Serruys PW
Nat Rev Cardiol 2018 Jun;15(6):321-331. doi: 10.1038/s41569-018-0001-4. PMID: 29599504
Classical electrocardiographic clues for left main coronary artery disease.
Sen F, Ozeke O, Kirbas O, Burak C, Kafes H, Tekin Tak B, Ozdamar U, Ocak K, Topaloglu S, Aras D
Indian Heart J 2016 Sep;68 Suppl 2(Suppl 2):S226-S227. Epub 2016 Apr 3 doi: 10.1016/j.ihj.2016.03.025. PMID: 27751297Free PMC Article
Left main coronary artery stenosis: state-of-the-art.
El-Menyar AA, Al Suwaidi J, Holmes DR Jr
Curr Probl Cardiol 2007 Mar;32(3):103-93. doi: 10.1016/j.cpcardiol.2006.12.002. PMID: 17382834

Therapy

Left main coronary artery disease: pathophysiology, diagnosis, and treatment.
Collet C, Capodanno D, Onuma Y, Banning A, Stone GW, Taggart DP, Sabik J, Serruys PW
Nat Rev Cardiol 2018 Jun;15(6):321-331. doi: 10.1038/s41569-018-0001-4. PMID: 29599504
Percutaneous coronary intervention versus coronary artery bypass grafting: where are we after NOBLE and EXCEL?
Fortier JH, Shaw RE, Glineur D, Grau JB
Curr Opin Cardiol 2017 Nov;32(6):699-706. doi: 10.1097/HCO.0000000000000450. PMID: 28786862
Update on percutaneous intervention for left main coronary artery stenosis.
Lee PH, Ahn JM, Park SJ
Expert Rev Cardiovasc Ther 2015;13(8):933-43. Epub 2015 Jul 9 doi: 10.1586/14779072.2015.1065730. PMID: 26159652
Left main coronary artery stenosis: a meta-analysis of drug-eluting stents versus coronary artery bypass grafting.
Athappan G, Patvardhan E, Tuzcu ME, Ellis S, Whitlow P, Kapadia SR
JACC Cardiovasc Interv 2013 Dec;6(12):1219-30. doi: 10.1016/j.jcin.2013.07.008. PMID: 24355112
Left main coronary artery stenosis: state-of-the-art.
El-Menyar AA, Al Suwaidi J, Holmes DR Jr
Curr Probl Cardiol 2007 Mar;32(3):103-93. doi: 10.1016/j.cpcardiol.2006.12.002. PMID: 17382834

Prognosis

Assessment of left main coronary artery disease: a comparison between invasive and noninvasive.
Alalawi LH, Dookhan CM, Verghese D, Manubolu VS, Aldana-Bitar J, Lakshmanan S, Ahmad K, Shafter A, Alchokhachi Z, Ghanem A, Golub IS, Budoff M, Roy S
Coron Artery Dis 2022 Sep 1;33(6):490-498. Epub 2022 Jun 22 doi: 10.1097/MCA.0000000000001154. PMID: 35757932
Left main coronary artery disease: pathophysiology, diagnosis, and treatment.
Collet C, Capodanno D, Onuma Y, Banning A, Stone GW, Taggart DP, Sabik J, Serruys PW
Nat Rev Cardiol 2018 Jun;15(6):321-331. doi: 10.1038/s41569-018-0001-4. PMID: 29599504
Classical electrocardiographic clues for left main coronary artery disease.
Sen F, Ozeke O, Kirbas O, Burak C, Kafes H, Tekin Tak B, Ozdamar U, Ocak K, Topaloglu S, Aras D
Indian Heart J 2016 Sep;68 Suppl 2(Suppl 2):S226-S227. Epub 2016 Apr 3 doi: 10.1016/j.ihj.2016.03.025. PMID: 27751297Free PMC Article
Exploring coronary atherosclerosis with intravascular imaging.
Puri R, Tuzcu EM, Nissen SE, Nicholls SJ
Int J Cardiol 2013 Sep 30;168(2):670-9. Epub 2013 Apr 7 doi: 10.1016/j.ijcard.2013.03.024. PMID: 23571162
Percutaneous coronary intervention for unprotected left main coronary artery stenosis.
Park SJ, Kim YH
Cardiol Clin 2010 Feb;28(1):81-95. doi: 10.1016/j.ccl.2009.09.001. PMID: 19962051

Clinical prediction guides

Left main coronary artery disease: pathophysiology, diagnosis, and treatment.
Collet C, Capodanno D, Onuma Y, Banning A, Stone GW, Taggart DP, Sabik J, Serruys PW
Nat Rev Cardiol 2018 Jun;15(6):321-331. doi: 10.1038/s41569-018-0001-4. PMID: 29599504
Classical electrocardiographic clues for left main coronary artery disease.
Sen F, Ozeke O, Kirbas O, Burak C, Kafes H, Tekin Tak B, Ozdamar U, Ocak K, Topaloglu S, Aras D
Indian Heart J 2016 Sep;68 Suppl 2(Suppl 2):S226-S227. Epub 2016 Apr 3 doi: 10.1016/j.ihj.2016.03.025. PMID: 27751297Free PMC Article
Left main coronary artery stenosis: a meta-analysis of drug-eluting stents versus coronary artery bypass grafting.
Athappan G, Patvardhan E, Tuzcu ME, Ellis S, Whitlow P, Kapadia SR
JACC Cardiovasc Interv 2013 Dec;6(12):1219-30. doi: 10.1016/j.jcin.2013.07.008. PMID: 24355112
Exploring coronary atherosclerosis with intravascular imaging.
Puri R, Tuzcu EM, Nissen SE, Nicholls SJ
Int J Cardiol 2013 Sep 30;168(2):670-9. Epub 2013 Apr 7 doi: 10.1016/j.ijcard.2013.03.024. PMID: 23571162
Angina in the elderly.
Duprez DA
Eur Heart J 1996 Dec;17 Suppl G:8-13. doi: 10.1093/eurheartj/17.suppl_g.8. PMID: 8960449

Recent systematic reviews

Transradial Versus Transfemoral Access for Percutaneous Coronary Intervention of Unprotected Left Main Coronary Artery Stenosis: A Systematic Review and Meta-Analysis.
Bajaj A, Pancholy S, Sothwal A, Nawaz Y, Boruah P
Cardiovasc Revasc Med 2019 Sep;20(9):790-798. Epub 2018 Nov 3 doi: 10.1016/j.carrev.2018.10.025. PMID: 30442537
Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis: A Systematic Review and Meta-analysis.
Giacoppo D, Colleran R, Cassese S, Frangieh AH, Wiebe J, Joner M, Schunkert H, Kastrati A, Byrne RA
JAMA Cardiol 2017 Oct 1;2(10):1079-1088. doi: 10.1001/jamacardio.2017.2895. PMID: 28903139Free PMC Article
Percutaneous intervention versus coronary artery bypass graft surgery in left main coronary artery stenosis: a systematic review and meta-analysis.
Zhang XL, Zhu QQ, Yang JJ, Chen YH, Li Y, Zhu SH, Xie J, Wang L, Kang LN, Xu B
BMC Med 2017 Apr 21;15(1):84. doi: 10.1186/s12916-017-0853-1. PMID: 28427392Free PMC Article
Left main coronary artery stenosis: a meta-analysis of drug-eluting stents versus coronary artery bypass grafting.
Athappan G, Patvardhan E, Tuzcu ME, Ellis S, Whitlow P, Kapadia SR
JACC Cardiovasc Interv 2013 Dec;6(12):1219-30. doi: 10.1016/j.jcin.2013.07.008. PMID: 24355112
Meta-analysis and systematic review of the long-term predictive value of assessment of coronary atherosclerosis by contrast-enhanced coronary computed tomography angiography.
Bamberg F, Sommer WH, Hoffmann V, Achenbach S, Nikolaou K, Conen D, Reiser MF, Hoffmann U, Becker CR
J Am Coll Cardiol 2011 Jun 14;57(24):2426-36. doi: 10.1016/j.jacc.2010.12.043. PMID: 21658564

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