Right Posterior Descending Artery Versus Left Posterior Descending Artery Percutaneous Coronary Intervention: Is There a Difference in Outcome?.

Abstract

Background: Coronary artery dominance has previously been described as a significant predictor of risk when undertaking percutaneous coronary intervention (PCI). PCI for left posterior descending artery (L-PDA) lesions involves wiring the left main coronary artery and more challenging angiographic projection of the circumflex-PDA. This may portend a higher risk as compared to posterior descending artery (R-PDA) PCI. We sought to compare characteristics and outcomes of R-PDA versus L-PDA PCI. Method(s): The Victorian Cardiac Outcomes Registry is a state-wide quality registry with all PCI capable centres in Victoria contributing. We undertook retrospective analysis of patients undergoing PCI for L-PDA and R-PDA lesions between 2013 and 2022. Result(s): 2,880 patients were included over the 10-year study period, 2,282 (79.2%) undergoing R-PDA PCI and 598 (20.8%) undergoing L-PDA PCI. Patient characteristics between groups were of similar age (66.3 years in both groups), gender (17.9% vs 14.5%; p=0.06) and had comparable rates of comorbidities such as diabetes (25.8% vs 24.9%; p=0.66). Femoral approach PCI was more common in the R-PDA group (35.6% vs 29.1%; p=0.003). There was no significant difference between groups with respect to 30-day mortality (1.1% vs 0.5%; p=0.21). 30-day MACE was also comparable (2.2% both groups; p=0.93). Conclusion(s): In contrast to earlier series, our data from a large contemporary cohort did not find any association between coronary dominance and outcomes when intervening upon the PDA.Copyright � 2024