Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis

Introduction:Successful revascularization of lesions located in the left main and/or proximal left anterior descending (LM and/or pLAD) coronary artery improves survival than medical therapy only. Therefore, accurate identification of high-risk patients with suspected stable angina pectoris is criti...

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Autores principales:	Ömer Faruk Çırakoğlu, Sinan Şahin, Ahmet Seyda Yılmaz
Formato:	article
Lenguaje:	EN
Publicado:	Galenos Yayinevi 2021
Materias:	left anterior fascicular block obstructive left main coronary artery lesion obstructive proximal left anterior descending coronary artery lesion stable angina pectoris Medicine R
Acceso en línea:	https://doaj.org/article/9cf4848dcb5a4bd8aa0b1a9d55e65335
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spelling	oai:doaj.org-article:9cf4848dcb5a4bd8aa0b1a9d55e653352021-11-23T10:25:25ZEvaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis2619-97932148-094X10.4274/imj.galenos.2021.08365https://doaj.org/article/9cf4848dcb5a4bd8aa0b1a9d55e653352021-11-01T00:00:00Z http://istanbulmedicaljournal.org/archives/archive-detail/article-preview/evaluation-of-the-predictive-value-of-left-anterio/49712 https://doaj.org/toc/2619-9793https://doaj.org/toc/2148-094XIntroduction:Successful revascularization of lesions located in the left main and/or proximal left anterior descending (LM and/or pLAD) coronary artery improves survival than medical therapy only. Therefore, accurate identification of high-risk patients with suspected stable angina pectoris is critical for outpatient clinics. Since the septal perforators of the left anterior descending coronary artery are the main source of blood supply of the left anterior fascicle, we hypothesized that the presence of left anterior fascicular block (LAFB) can predict obstructive stenoses of LM and/or pLAD coronary arteries in patients with suspected stable angina pectoris.Methods:We consecutively enrolled 790 patients referred for invasive coronary angiography due to suspected stable angina pectoris.Results:The number of patients with LAFBs was 68 (8.6%). Furthermore, 218 patients (27.6%) had obstructive coronary artery disease (CAD). The prevalence of obstructive CAD, revascularization with coronary artery bypass graft surgery, and obstructive LM and/or pLAD coronary artery lesions was higher in patients with LAFB. From univariate analysis, the presence of LAFB was significantly associated with predicting obstructive LM and/or pLAD lesions (odds ratio: 3,587; 95% confidence interval: 1,465-5,785; p=0.005). However, this association disappeared after adjustment for other cardiovascular risk factors.Conclusion:In patients with suspected stable angina pectoris, LAFB is not frequently a “normal variant” and is associated with known cardiovascular risk factors. It acts as a marker rather than a determinant of obstructive LM and/or pLAD coronary artery lesions.Ömer Faruk ÇırakoğluSinan ŞahinAhmet Seyda YılmazGalenos Yayineviarticleleft anterior fascicular blockobstructive left main coronary artery lesionobstructive proximal left anterior descending coronary artery lesionstable angina pectorisMedicineRENİstanbul Medical Journal, Vol 22, Iss 4, Pp 287-293 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	left anterior fascicular block obstructive left main coronary artery lesion obstructive proximal left anterior descending coronary artery lesion stable angina pectoris Medicine R
spellingShingle	left anterior fascicular block obstructive left main coronary artery lesion obstructive proximal left anterior descending coronary artery lesion stable angina pectoris Medicine R Ömer Faruk Çırakoğlu Sinan Şahin Ahmet Seyda Yılmaz Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
description	Introduction:Successful revascularization of lesions located in the left main and/or proximal left anterior descending (LM and/or pLAD) coronary artery improves survival than medical therapy only. Therefore, accurate identification of high-risk patients with suspected stable angina pectoris is critical for outpatient clinics. Since the septal perforators of the left anterior descending coronary artery are the main source of blood supply of the left anterior fascicle, we hypothesized that the presence of left anterior fascicular block (LAFB) can predict obstructive stenoses of LM and/or pLAD coronary arteries in patients with suspected stable angina pectoris.Methods:We consecutively enrolled 790 patients referred for invasive coronary angiography due to suspected stable angina pectoris.Results:The number of patients with LAFBs was 68 (8.6%). Furthermore, 218 patients (27.6%) had obstructive coronary artery disease (CAD). The prevalence of obstructive CAD, revascularization with coronary artery bypass graft surgery, and obstructive LM and/or pLAD coronary artery lesions was higher in patients with LAFB. From univariate analysis, the presence of LAFB was significantly associated with predicting obstructive LM and/or pLAD lesions (odds ratio: 3,587; 95% confidence interval: 1,465-5,785; p=0.005). However, this association disappeared after adjustment for other cardiovascular risk factors.Conclusion:In patients with suspected stable angina pectoris, LAFB is not frequently a “normal variant” and is associated with known cardiovascular risk factors. It acts as a marker rather than a determinant of obstructive LM and/or pLAD coronary artery lesions.
format	article
author	Ömer Faruk Çırakoğlu Sinan Şahin Ahmet Seyda Yılmaz
author_facet	Ömer Faruk Çırakoğlu Sinan Şahin Ahmet Seyda Yılmaz
author_sort	Ömer Faruk Çırakoğlu
title	Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
title_short	Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
title_full	Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
title_fullStr	Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
title_full_unstemmed	Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
title_sort	evaluation of the predictive value of left anterior fascicular block on determination of left main and/or proximal left anterior descending coronary artery disease in patients with stable angina: a propensity score matching analysis
publisher	Galenos Yayinevi
publishDate	2021
url	https://doaj.org/article/9cf4848dcb5a4bd8aa0b1a9d55e65335
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Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis

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