Trends in Unprotected Left Main Percutaneous Coronary Intervention and Clinical Outcomes

What are recent temporal trends in the use and in-hospital outcomes of unprotected left main percutaneous coronary intervention (LM PCI) in Japan?In this nationwide cohort study of 851 468 PCI procedures (2019-2023), unprotected LM PCI consistently represented about 5% of all cases. Mean patient age increased and patients had more comorbidities over time, while unadjusted in-hospital mortality rose slightly (from 1.6% in 2019 to 1.9% in 2023); however, after adjustment for patient and procedural characteristics, mortality rates remained stable.The findings of this study suggest that LM PCI has been increasingly adopted in higher-risk patients in Japan while maintaining stable short-term outcomes, supporting its continued role in contemporary revascularization practice.

Corresponding Author: Nobuhiro Ikemura, MD, PhD, Saint Luke’s Mid America Heart Institute, 4401 Wornall Rd, Kansas City, MO 64011 (ikemu0129@gmail.com).

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