Author + information
- Received August 9, 2010
- Revision received October 4, 2010
- Accepted October 4, 2010
- Published online March 22, 2011.
- Jong-Young Lee, MD⁎,
- Duk-Woo Park, MD, PhD⁎,
- Young-Hak Kim, MD, PhD⁎,
- Sung-Cheol Yun, PhD†,
- Won-Jang Kim, MD, PhD⁎,
- Soo-Jin Kang, MD, PhD⁎,
- Seung-Whan Lee, MD, PhD⁎,
- Cheol-Whan Lee, MD, PhD⁎,
- Seong-Wook Park, MD, PhD⁎ and
- Seung-Jung Park, MD, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Seung-Jung Park, Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea
Objectives The aim of this study was to evaluate the incidence, predictors, and long-term outcomes of patients with in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for unprotected left main coronary artery (LMCA) disease.
Background Few data on the clinical course and management of patients experiencing restenosis after DES treatment for unprotected LMCA disease have appeared.
Methods Between February 2003 and November 2007, 509 consecutive patients with unprotected LMCA disease underwent DES implantation, with 402 (80.1%) undergoing routine surveillance or clinically driven angiographic follow-up. A major adverse cardiac event was defined as the composite of death, myocardial infarction (MI), or target-lesion revascularization.
Results The overall incidence of angiographic ISR in LMCA lesions was 17.6% (71 of 402 patients, 57 with focal-type and 14 with diffuse-type ISR. Forty patients (56.3%) underwent repeated PCI, 10 (14.1%) underwent bypass surgery, and 21 (29.6%) were treated medically. During long-term follow-up (a median of 31.7 months), there were no deaths, 1 (2.2%) MI, and 6 (9.5%) repeated target-lesion revascularization cases. The incidence of major adverse cardiac event was 14.4% in the medical group, 13.6% in the repeated PCI group, and 10.0% in the bypass surgery group (p = 0.91). Multivariate analysis showed that the occurrence of DES-ISR did not affect the risk of death or MI.
Conclusions The incidence of ISR was 17.7% after DES stenting for LMCA. The long-term clinical prognosis of patients with DES-ISR associated with LMCA stenting might be benign, given that these patients were optimally treated with the clinical judgment of the treating physician.
All authors have reported that they have no relationships to disclose.
- Received August 9, 2010.
- Revision received October 4, 2010.
- Accepted October 4, 2010.
- American College of Cardiology Foundation