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Isolated and Significant Left Main Coronary Artery Disease: Demographics, Hemodynamics and Angiographic Features

Department of Medicine, Maimonides Medical Center, Brooklyn, NY; Bldg 902, 47th Street, Apt RB4, Brooklyn, NY 11219 nmahajan{at}maimonidesmed.org

Gerald Hollander, MD

Bilal Malik, MD

Department of Cardiology, Maimonides Medical Center, Brooklyn, NY

Brian Temple, MD

Department of Medicine, Maimonides Medical Center, Brooklyn, NY

Deepak Thekkoott, MD

Department of Cardiology, Maimonides Medical Center, Brooklyn, NY

Sunil Abrol, MD

Nancy Schulhoff, MD

Department of Cardiothoracic Surgery, Maimonides Medical Center, Brooklyn, NY

Joydeep Ghosh, MD

Jacob Shani, MD

Department of Cardiology, Maimonides Medical Center, Brooklyn, NY

Edgar Lichstein, MD

Department of Medicine, Maimonides Medical Center, Brooklyn, NY

Left main coronary artery disease carries a poor prognosis. The etiology of isolated and significant left main coronary artery (ILMCA) disease is not well understood. Studies so far were limited by small numbers. The authors identified 46 patients with ILMCA disease from their database over 10 years (group I) and compared them with 83 consecutive patients undergoing catheterization (group II). They also compared patients with ostial vs distal ILMCA disease. Group I represented 0.1% of catheterization patients. The demographic profile and atherosclerotic risk factor profile of the 2 groups as well as ostial and distal ILMCA disease were compared. This is the largest study of ILMCA disease. Risk factors for atherosclerosis were commonly seen. Nonatherosclerotic causes of ILMCA disease were not seen. This study suggests coronary atherosclerosis as the predominant cause of ILMCA disease. ILMCA disease is more common in women. Diabetes is more commonly associated with distal ILMCA lesion. There is a trend suggesting that ostial ILMCA lesion is more common in smokers and women.

Angiology, Vol. 57, No. 4, 464-477 (2006)
DOI: 10.1177/0003319706290740


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