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How to deal with LM Disease in NSTEMI patient: PCI or CABG?

Heart Science Journal · Vol. 4 No. 2 (2023) · hlm. 26–33

DOI
10.21776/ub.hsj.2023.004.02.6
ISSN
2721-9984, 2721-9976
Terbit
2023-04-01
Penerbit
Universitas Brawijaya
Bahasa
en

Abstrak

 Background: The left main coronary artery (LMCA) with acute coronary syndrome have been associated with significant morbidity and mortality. Urgent CABG is recommended for patients with LM disease accompanied by ACS, but requires special preparation and adequate facilities. not all hospitals are ready. PCI on left main coronary artery is a high risk procedure which requires special preparation like IVUS and FFR. Meanwhile, the ACS case is an emergency that needs to be treated immediately. Interventional management is mandatory in this setting, but the concern is whether the action is carried out in an emergency or an elective procedure.Objective: This study aimed to describe the management of LM disease in NSTEMI patients.Case presentation: We will discuss a 69-year-old male brought to our hospital because of chest pain while doing moderate activity. The patient was previously referred from a private hospital and was assessed as NSTEACS. from angiography there was Stenosis dd Thrombus at LM, the cardiologist suggest him to be referred to RSSA for CVCU admission and will be underwent Urgent revascularisation. Clopidogrel and aspirin were routinely consumed as dual antiplatelet therapy. We treat the patient with an unfractionated heparin (UFH) bolus, continued with continuous infusion until revascularization. No event of subsequent acute coronary syndrome was observed.Conclusion: Although the management of patients with LM disease requires some preparation before action is taken, urgent revascularization in Acute coronary syndrome cases must still be carried out immediately.

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  • University of Brawijaya
  • RSUD Prof. Dr. Saiful Anwar Malang
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Rekan penulisOrganisasiArtikel bersama
Indra PrasetyaUniversity of Brawijaya27
Setyasih AnjarwaniUniversity of Brawijaya27
Cholid Tri TjahjonoUniversity of Brawijaya26
Anna Fuji RahimahUniversity of Brawijaya24
Ardian RizalUniversity of Brawijaya21
Novi KurnianingsihUniversity of Brawijaya20
Djanggan SargowoUniversity of Brawijaya16
Sasmojo WiditoUniversity of Brawijaya16
Heny MartiniUniversity of Brawijaya12
Yoga WaranugrahaUniversity of Brawijaya11
Muhammad Rizki FadlanUniversity of Brawijaya6
Putri Annisa KamilaUniversity of Brawijaya5
Anna Fuji RahimahAfiliasi tidak diketahui5
Adhika Prastya WikanandaUniversity of Brawijaya4
Tri AstiawatiUniversity of Brawijaya4
Dadang HendrawanUniversity of Brawijaya4
Hayla Iqda MillisaniUniversity of Brawijaya4
Fandy HazzyUniversity of Brawijaya3
Wella KarolinaUniversity of Brawijaya3
Oktivani Adelathifa RahmaUniversity of Brawijaya3
Olivia HandayaniUniversity of Brawijaya3
Dea Arie KurniawanUniversity of Brawijaya3
Ayu Asri Devi AdityawatiUniversity of Brawijaya3
Seprian WidasmaraUniversity of Brawijaya3
Valerinna YogibuanaAfiliasi tidak diketahui3
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya3
Shalahuddin Suryo BaskoroUniversity of Brawijaya3
Nikhen NoverikeUniversity of Brawijaya3
Zhafran VeliawanUniversity of Brawijaya3
Veny KurniawatiUniversity of Brawijaya2
Tonny AdriyantoUniversity of Brawijaya2
Jonny Karunia FajarUniversity of Brawijaya2
Fahmy RusnantaUniversity of Brawijaya2
Fitranti Suciati LaitupaUniversity of Brawijaya2
Oktafin Srywati PamunaUniversity of Brawijaya2
Liemena Harold AdrianRSUD Prof. Dr. Saiful Anwar Malang2

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">How to deal with LM Disease in NSTEMI patient: PCI or CABG?</dc:title>
	<dc:creator xml:lang="en">Zunardi, Lutfi Hafiz</dc:creator>
	<dc:creator xml:lang="en">Rohman, Mohammad Saifur</dc:creator>
	<dc:creator xml:lang="en">Satrijo, Budi</dc:creator>
	<dc:creator xml:lang="en">Nugraha, Adriawan Widiya</dc:creator>
	<dc:subject xml:lang="en">Left Main disease</dc:subject>
	<dc:subject xml:lang="en">Percutaneous Coronary Intervention</dc:subject>
	<dc:subject xml:lang="en">Acute coronary syndrom</dc:subject>
	<dc:subject xml:lang="en">Non ST Elevetion Segment Myocardial infacrtion</dc:subject>
	<dc:subject xml:lang="en">Unstable Angina Pectoris</dc:subject>
	<dc:subject xml:lang="en">Coronary Artery Bypass Graft Surgery.</dc:subject>
	<dc:description xml:lang="en"> Background: The left main coronary artery (LMCA) with acute coronary syndrome have been associated with significant morbidity and mortality. Urgent CABG is recommended for patients with LM disease accompanied by ACS, but requires special preparation and adequate facilities. not all hospitals are ready. PCI on left main coronary artery is a high risk procedure which requires special preparation like IVUS and FFR. Meanwhile, the ACS case is an emergency that needs to be treated immediately. Interventional management is mandatory in this setting, but the concern is whether the action is carried out in an emergency or an elective procedure.Objective: This study aimed to describe the management of LM disease in NSTEMI patients.Case presentation: We will discuss a 69-year-old male brought to our hospital because of chest pain while doing moderate activity. The patient was previously referred from a private hospital and was assessed as NSTEACS. from angiography there was Stenosis dd Thrombus at LM, the cardiologist suggest him to be referred to RSSA for CVCU admission and will be underwent Urgent revascularisation. Clopidogrel and aspirin were routinely consumed as dual antiplatelet therapy. We treat the patient with an unfractionated heparin (UFH) bolus, continued with continuous infusion until revascularization. No event of subsequent acute coronary syndrome was observed.Conclusion: Although the management of patients with LM disease requires some preparation before action is taken, urgent revascularization in Acute coronary syndrome cases must still be carried out immediately.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2023-04-01</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/6159</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2023.004.02.6</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 4 No. 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease; 26-33</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2023.004.02</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/6159/355</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2023 Lutfi hafiz zunardi, Mohammad Saifur Rohman, Budi Satrijo, Adriawan Widiya Nugraha</dc:rights>
</oai_dc:dc>