Authors:

Truc Quynh Pham

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Background: Left Main Coronary Artery Disease (LMCAD) poses a significant therapeutic challenge in elderly patients due to elevated procedural risks and common comorbidities. In Vietnam, the aging population and limited access to advanced interventional therapies further complicates clinical decision-making. This study aimed to evaluate the current management strategies for LMCAD in elderly Vietnamese patients and identify clinical factors associated with treatment outcomes. Methods: A retrospective study was conducted on 48 patients aged ?60 years diagnosed with LMCAD at a geriatric tertiary hospital in Vietnam over a 6-month period. Patients with incomplete records or concurrent terminal illness were excluded. Data were extracted from medical records, including demographics, comorbidities, treatment modalities, echocardiographic parameters, and biochemical test profiles. Statistical analyses included descriptive statistics, paired t-tests for continuous variables, and chi-square or Fisher's exact test for categorical variables. Results: The mean age was 71 ± 7.5 years; 58.3% were male. Common comorbidities included hypertension (95.8%), diabetes (47.9%), and chronic kidney disease (31.3%). Medical therapy was the most utilized approach. Primary percutaneous coronary intervention (PCI) was performed in 37.5% of cases, with 33.3% experiencing delayed presentation (>48 hours). The mean BCIS-JS score improved from 11.2 to 7.0 post-intervention. Mean LVEF at discharge was 56.6 ± 14.4%. Significant correlations (p < 0.05) were observed between treatment decisions and factors such as prior stroke, mitral regurgitation, GRACE score, BCIS-JS, and LDL-c levels. Conclusion: † Presenting Undergrad Author; ‡ Contributing Undergrad Author; * Undergrad Acknowledgment Timely PCI and individualized medical therapy improve cardiac function in elderly LMCAD patients. Elevated LDL-c and delayed intervention predict poorer outcomes, highlighting the need for early risk stratification. Keywords: Left Main Coronary Artery Disease; Elderly Vietnamese; Interventional Therapies; Percutaneous Coronary Intervention

Source:

Purdue University / 2025

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Truc Quynh Pham