{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:12:32Z","timestamp":1788448352743,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T00:00:00Z","timestamp":1725494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although data suggests ad hoc percutaneous coronary intervention\u00a0(PCI) results in similar patient outcomes compared to planned PCI in nonselected patients, data for ad hoc unprotected left main stem PCI (uLMS\u2010PCI) are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine if in\u2010hospital outcomes of uLMS\u2010PCI vary by ad hoc versus planned basis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were analyzed from all patients undergoing uLMS\u2010PCI in the United Kingdom 2006\u20132018, and patients grouped into uLMS\u2010PCI undertaken on an ad hoc or a planned basis. Patients who presented with ST\u2010segment elevation, cardiogenic shock, or with an emergency PCI indication were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 8574 uLMS\u2010PCI procedures were undertaken with 2837 (33.1%) of procedures performed on an ad hoc basis. There was a lower likelihood of intervention for stable angina (28.8% vs. 53.8%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and a higher rate of potent P2Y12 inhibitor use (16.4% vs. 12.1%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in the ad hoc PCI group compared to the planned PCI group. Patients undergoing uLMS\u2010PCI on an ad hoc basis tended to undergo less complex procedures. Acute procedural complications including slow flow (odds ratio [OR]: 1.70, 95%\u00a0confidence interval [CI]: 1.01\u20132.86), coronary dissection (OR: 1.41, 95% CI: 1.12\u20131.77) and shock induction (OR: 2.80, 95% CI: 1.64\u20134.78) were more likely in the ad hoc PCI group. In\u2010hospital death (OR: 1.65, 95% CI: 1.19\u20132.27) and in\u2010hospital major adverse cardiac or cerebrovascular events\u00a0(OR: 1.50, 95% CI: 1.13\u20131.98) occurred more frequently in the ad hoc group. In sensitivity analyses, these observations did not differ when several subgroups were separately examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ad hoc PCI for uLMS disease is associated with adverse outcomes compared to planned PCI. These data should inform uLMS\u2010PCI procedural planning.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31210","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T09:50:01Z","timestamp":1725529801000},"page":"697-706","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["In\u2010hospital outcomes of ad hoc versus\u00a0planned PCI for unprotected left\u2010main disease: An analysis of 8574 cases from British Cardiovascular Intervention Society database 2006\u20132018"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-3534","authenticated-orcid":false,"given":"Tim","family":"Kinnaird","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasim","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8992-9120","authenticated-orcid":false,"given":"Majd B.","family":"Protty","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Cranch","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peader","family":"Devlin","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Sharp","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Curzen","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital NHS Trust Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ludman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Queen Elizabeth Hospital Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hildick\u2010Smith","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sussex Cardiac Centre Brighton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Cardiology Bristol Royal Infirmary Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamas A.","family":"Mamas","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Stoke Hospital, UHNM Stoke\u2010on\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24701"},{"key":"e_1_2_9_3_1","first-page":"487","article-title":"Does ad hoc coronary intervention reduce radiation exposure? 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