In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

GRACE left main study: unprotected left main revascularization in patients with acute coronary syndromes

Hot Line II

Acute Coronary Syndromes (ACS)

Read the press release

Presenter | see Discussant report

Gilles Montalescot (France)






 Discussant | see Presenter abstract


Christian Hamm, FESC (Germany)







Presentation webcast

Presentation slides


In patients with acute coronary syndromes undergoing coronary angiography main stem lesions are found in approximately 5% of the cases. The treatment decision in this high risk subset is regularly difficult, because surgery in developing myocardial infarction is problematic and angioplasty technically demanding. Evidence for treatment decisions in such scenarios cannot be derived from randomised trials, but must come from carefully conducted registries.
In this context, the GRACE data provide valuable information for the management of these patients. It is self explaining that the mortality is high and the confounding factors are too complex to make conclusions with respect to the best treatment modality. The decision making has to be very individual and depends also on the local expertise and circumstances.
There is a strong trend over the observation period of 7 years to acutely perform more angioplasties and to delay surgery to following days. Therefore, these data reassure of what is currently done across the world and support the use of revascularisation techniques whatever and whenever feasible.




Unprotected left main revascularization in patients with acute coronary syndromes. GRACE left main study

Notes to editor

This congress report accompanies a presentation given at the ESC Congress 2009. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.