Patient Demographics:
81 yrs, Male
Present Clinical Presentation:
Presented with CCS Class Ill angina
CAD Risk Factors:
Hypertension, ex-smoker, severe obesity, paroxysmal atrial fibrillation (off anticoagulation after ablation)
Clinical Variables:
Positive SPECT-MPI, Prior multiple PCIs (proximal-LAD [SYNERGY 3.5/16], mid-, distal-
LAD, distal LCX, and RI, EF 60% on echo.
LDL: 124, SCr: 1.2, HbA1c: 5.9
Medications:
Aspirin, Clopidogrel, Atorvastatin, Evolocumab, Amlodipine, Lisinopril
Cath:
Cardiac cath on 3/19/2026 @MSH revealed 70-80% distal LMCA, 70-80% proximal LAD ISR, and 70-80% diffuse LCX lesion, 50% Ri and SYNTAX Score 32. A heart team discussion was conducted, but PCI was preferred by the patient.
Plan: Now planned for IVUS-guided PCI for the LM bifurcation, including LAD ISR lesion.
