Author + information
- Shunsuke Kubo,
- Kazushige Kadota,
- Seiji Habara,
- Takeshi Tada,
- Hiroyuki Tanaka,
- Yasushi Fuku,
- Harumi Katoh,
- Tsuyoshi Goto and
- Kazuaki Mitsudo
The superiority of drug–eluting stents (DES) over bare–metal stents (BMS) 7 years after unprotected left main coronary artery (ULMCA) stenting is little known.
From 2003 to 2005, 250 patients with coronary artery disease underwent ULMCA stenting (DES: 128, BMS: 122; acute coronary syndrome cases excluded). We compared the clinical outcomes, including cardiac death, non–fatal myocardial infarction (MI), and target lesion revascularization (TLR), between patients who received DES and BMS.
Median follow–up duration was 2623 days. The incidence of cardiac death or non–fatal MI at 7 years was similar between the 2 groups (DES, 9.2%; BMS, 11.9%; p = 0.59). The incidence of 7–year TLR was significantly lower in the DES group than in the BMS group (27.1% vs. 37.8%, p = 0.026); the incidence from 1 to 4 years and that beyond 4 years were similar between the 2 groups (Figure A). Among patients with bifurcation lesions, whereas the incidence of 7–year TLR was significantly lower in the DES group than the BMS group in patients undergoing single–stent procedures, it was similar between the 2 groups among patients undergoing two–stent procedures (Figure B).
Hard outcomes, including cardiac death and MI, of patients undergoing ULMCA stenting for 7 years were favorable whether after DES or BMS implantation. The TLR rate after DES implantation, without using the two–stent procedure, was superior to that after BMS implantation when considering TLR during the late phase.
West, Room 2022
Saturday, March 09, 2013, 8:15 a.m.–8:25 a.m.
Session Title: Left Main and Bifurcation PCI
Abstract Category: 46. TCT@ACC–i2: Coronary Intervention, LM/Bifurcations
Presentation Number: 2901–2
- 2013 American College of Cardiology Foundation