{
    "abstract": "Anatomically severe left main coronary artery (LMCA) stenosis (>50%) remains one of the few groups to benefit from early revascularization in stable ischemic heart disease (SIHD). Identification of these patients through widely available noninvasive testing would decrease the need for additional upfront anatomic testing, lowering the overall cost of healthcare. Patients with SIHD who underwent either percutaneous or surgical revascularization over a 7-year period at our institution were retrospectively analyzed and categorized as having LMCA stenosis versus non-LM stenosis. All preceding noninvasive testing, including resting electrocardiogram, echocardiogram, and functional testing was evaluated and compared between groups using chi-square and t test. In total, 806 patients were evaluated. Of those, 121 were identified as having significant LMCA stenosis with 685 patients in the non-LM cohort. Between LMCA versus non-LM cohorts, there were similar rates of electrocardiogram abnormalities (68.9% vs 70.8%, p >0.05), abnormal echocardiograms (72.7% vs 69.7%, p >0.05), abnormal functional testing (83.3% vs 77.4%, p >0.05), and high-risk imaging findings (5.6% vs 4.8%, p >0.05). More importantly, of those with a complete workup, there were similar rates of normal results between the LMCA (3 of 18, 16.7%) and non-LM stenosis (9 of 189, 4.8%) groups. A comprehensive noninvasive profile of patients with IHD failed to identify or exclude patients with anatomically severe LMCA stenosis, necessitating anatomic assessment.",
    "authors": [
        {
            "affiliation": "Department of Cardiovascular Medicine, University of Kentucky Medical Center, Lexington, Kentucky. Electronic address: thomas.wool@uky.edu.",
            "firstname": "Thomas H",
            "initials": "TH",
            "lastname": "Wool"
        },
        {
            "affiliation": "University of Kentucky College of Medicine, University of Kentucky Medical Center, Lexington, Kentucky.",
            "firstname": "Sarah C",
            "initials": "SC",
            "lastname": "Ashley"
        },
        {
            "affiliation": "Department of Cardiovascular Medicine, University of Kentucky Medical Center, Lexington, Kentucky.",
            "firstname": "Vedant A",
            "initials": "VA",
            "lastname": "Gupta"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2023 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.amjcard.2023.07.055",
    "journal": "The American journal of cardiology",
    "keywords": [
        "left main coronary artery disease",
        "stable ischemic heart disease"
    ],
    "methods": null,
    "publication_date": "2023-08-14",
    "pubmed_id": "37573613",
    "results": null,
    "title": "Determination of Left Main Coronary Artery Stenosis Through Noninvasive Testing to Guide Revascularization in Ischemic Heart Disease.",
    "xml": "<Element 'PubmedArticle' at 0x788503597970>"
}