Difference in outcomes between right and left posterior descending artery percutaneous coronary intervention: an Australian statewide registry analysis

Percutaneous coronary intervention (PCI) is an important treatment for coronary artery disease, and coronary dominance may influence procedural risk. PCI to a left-sided posterior descending artery (L-PDA) occurs in the setting of left-dominant coronary anatomy and may involve greater anatomical complexity and a larger myocardial territory at risk than PCI to a right-sided PDA (R-PDA). We performed a retrospective analysis of a statewide registry to compare the characteristics and outcomes of R-PDA and L-PDA PCI.

The Victorian Cardiac Outcomes Registry is a state-wide quality registry with all PCI capable centres in Victoria, Australia contributing. We undertook a retrospective analysis of patients undergoing PCI for L-PDA and R-PDA lesions between 2013 and 2022.

2,880 patients were included over the 10-year study period, with 2,282 (79.2%) undergoing R-PDA PCI and 598 (20.8%) undergoing L-PDA PCI. Patient characteristics between groups were of similar age (66.3 years in both groups), gender (17.9% vs. 14.5%; p = 0.06) and had comparable rates of comorbidities including diabetes (25.8% vs. 24.9%; p = 0.66). There was no significant difference between groups with respect to 30-day mortality (1.1% vs. 0.5%; p = 0.21). 30-day MACE was also comparable (2.2% both groups; p = 0.93).

Data from a large contemporary cohort did not find any association between coronary dominance and clinical outcomes when undertaking PDA PCI.