Stenting vs. CABG for Unprotected Left Main CAD in a 72-Year-Old Patient
A 72-year-old female presents with unstable angina. She has a known history of coronary artery disease and had undergone coronary artery bypass grafting two years prior, with a saphenous vein graft anastomosed to the LAD as her LIMA was found to be atretic. Additional medical history is significant for hypertension, hyperlipidemia, and COPD with two exacerbations in the last month. Her ECG revealed sinus rhythm with poor R wave progression across the precordial leads, and non-specific T wave inversions. She underwent diagnostic left heart catheterization which revealed an occluded venous graft, a discrete 80% ostial left main lesion, 60% proximal LAD lesion, and up to 70% stenoses in the circumflex and right coronary artery. Echocardiography revealed preserved LV systolic function. Due to her significant lung disease, she was felt to be a better candidate for unprotected left main PCI rather than re-do CABG.
Based on the PRECOMBAT trial, which of the following statements is true for this patient: