Very Long-term Outcomes Following Drug-eluting Stent Implantation for Unprotected Left Main Coronary Artery Stenosis: A Single Center Experience

Ielasi, Alfonso; Latib, Azeem; Chieffo, Alaide; Takagi, Kensuke; Mussardo, Marco; Davidavičius, Giedrius; Godino, Cosmo; Carlino, Mauro; Montorfano, Matteo; Colombo, Antonio

doi:10.1016/j.rec.2012.06.016

Cited by 5 publications

(2 citation statements)

References 36 publications

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“…Although the success of these device iterations was proven by better outcomes in a general PCI population, little data are available on the potential benefit of the 2 nd ‐gen DES as compared to 1 st ‐gen DES in real world patients with ULMCA disease . Previous studies either primarily focused on 1 st ‐gen DES, lacked long‐term follow‐up or enrolled only selected patients . Therefore, the aim of this study was to assess the 5‐year clinical outcome of 1 st ‐gen versus 2 nd ‐gen DES for the treatment of ULMCA stenosis.…”

Section: Introductionmentioning

confidence: 99%

Long‐term outcome in patients treated with first‐ versus second‐generation drug‐eluting stents for the treatment of unprotected left main coronary artery stenosis

Zandvoort

Bommel

Masdjedi

et al. 2019

Cathet Cardio Intervent

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Objective and background The study aim is to provide long‐term clinical outcome after percutaneous coronary intervention (PCI) for unprotected left main coronary arteries (ULMCA) stenosis with the first‐generation (1st‐gen) drug‐eluting stents (DES) in comparison to 2nd‐gen DES, since this is largely unknown. Methods Between May 2002, and December 2014, a consecutive series of 656 all‐comer patients underwent a PCI for ULMCA stenosis at the Erasmus Medical Center. A total of 235 patients were treated with 1st‐gen DES, while a total of 421 patients were treated with 2nd‐gen DES. Results Overall, the population consisted of 73% males and 58% presented with an acute coronary syndrome. Median follow‐up time was 1,361 days (range from 0 to 5,031). At 5 years, the cumulative incidence of major adverse clinical events (the primary composite endpoint of all‐cause death, any myocardial infarction or target lesion revascularization; MACE) did not differ between 1st‐ and 2nd‐gen DES (36.8 vs. 38.6%, respectively, Log Rank p = .79, adjusted hazard ratio [HR] = 1.28 [95% confidence interval (CI) 0.94–1.74]). No difference was found in the individual endpoints of all‐cause mortality (29.5 vs. 29% respectively, p = .88, adjusted HR = 1.19 [95% CI, 0.84–1.68]), target vessel myocardial infarction (5.0 vs. 8.4%, p = 0.17, adjusted HR = 1.75 [95% CI, 0.78–3.96]) and target lesion revascularization (8.1 vs. 9.8%, p = .94, adjusted HR = 1.16 [95% CI, 0.59–2.29]) between the 1st‐ and 2nd‐gen DES cohorts, respectively. Conclusions In this large cohort of consecutive patients treated for ULMCA stenosis, no significant differences were found in the safety and efficacy of 1st versus 2nd‐gen DES at 5 years follow‐up.

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Section: Introductionmentioning

confidence: 99%

Long‐term outcome in patients treated with first‐ versus second‐generation drug‐eluting stents for the treatment of unprotected left main coronary artery stenosis

Zandvoort

Bommel

Masdjedi

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…This means that in daily clinical practice, a certain percentage of patients with LMCAD do not undergo revascularisation and can only choose medical treatment [6] [7]. The current natural history of patients with LMCAD without revascularisation is not well known, as current research series examining the outcomes of surgical [8] or percutaneous [9]- [12] treatments do not cover the evolution of non-revascularised patients. Furthermore, today patients with ischemic heart disease are generally treated with pharmacological measures that are associated with a better prognosis.…”

Section: Introductionmentioning

confidence: 99%