Long-Term Safety and Effectiveness of Unprotected Left Main Coronary Stenting With Drug-Eluting Stents Compared With Bare-Metal Stents

Author:

Kim Young-Hak1,Park Duk-Woo1,Lee Seung-Whan1,Yun Sung-Cheol1,Lee Cheol Whan1,Hong Myeong-Ki1,Park Seong-Wook1,Seung Ki Bae1,Gwon Hyeon-Cheol1,Jeong Myung-Ho1,Jang Yangsoo1,Kim Hyo-Soo1,Seong In-Whan1,Park Hun Sik1,Ahn Taehoon1,Chae In-Ho1,Tahk Seung-Jea1,Chung Wook-Sung1,Park Seung-Jung1

Affiliation:

1. From the Asan Medical Center, Seoul (Y.-H.K., D.-W.P., S-.W.L., S-.C.Y., C-.W.L., M-.K.H., S-.W.P., S.-J.P.); Catholic University of Korea, GangNam (K.B.S.) and Yeoido (W.-S.C.), Seoul; Samsung Medical Center, Seoul (H.-C.G.); Chonnam National University Hospital, Gwangju (M.-H.J.); Yonsei University Severance Hospital, Seoul (Y.J.); Seoul National University Hospital, Seoul (H.-S.K.) and Bundang (I.-H.C.); Chungnam National University Hospital, Daejeon (I.-W.S.); Kyungpook National University...

Abstract

Background— Limited information is available on long-term outcomes for patients with unprotected left main coronary artery disease who received drug-eluting stents (DES). Methods and Results— In the multicenter registry evaluating outcomes among patients with unprotected left main coronary artery stenosis undergoing stenting with either bare metal stents (BMS) or DES, 1217 consecutive patients were divided into 2 groups: 353 who received only BMS and 864 who received at least 1 DES. The 3-year outcomes were compared by use of the adjustment of inverse-probability-of-treatment-weighted method. Patients receiving DES were older and had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and multivessel disease. In the overall population, with the use of DES, the 3-year adjusted risk of death (8.0% versus 9.5%; hazard ratio, 0.71; 95% confidence interval, 0.36 to 1.40; P =0.976) or death or myocardial infarction (14.3% versus 14.9%; hazard ratio, 0.83; 95% confidence interval, 0.49 to 1.40; P =0.479) was similar compared with BMS. However, the risk of target lesion revascularization was significantly lower with the use of DES than BMS (5.4% versus 12.1%; hazard ratio, 0.40; 95% confidence interval, 0.22 to 0.73; P =0.003). When patients were classified according to lesion location, DES was still associated with lower risk of target lesion revascularization in patients with bifurcation (6.9% versus 16.3%; hazard ratio, 0.38; 95% confidence interval, 0.18 to 0.78; P =0.009) or nonbifurcation (3.4% versus 10.3%; hazard ratio, 0.39; 95% confidence interval, 0.17 to 0.88; P =0.024) lesions with a comparable risk of death or myocardial infarction. Conclusions— Compared with BMS, DES was associated with a reduction in the need for repeat revascularization without increasing the risk of death or myocardial infarction for patients with unprotected left main coronary artery stenosis.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Cited by 78 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3