Author + information
- Jaclyn Chi Lin Chan1,
- Ping Tim Tsui2,
- Dick Chi Yeung Cheung3,
- Alan Chan4,
- Li Wah Tam1,
- Eugene Brian Wu5,
- Michael Kang-Yin Lee4,
- Man-Hong Jim6,
- Tak Sun Tse7,
- Edmond Wong8,
- Yu Ho Chan9 and
- Kin Lam Tsui3
- 1Kwong Wah Hospital, Hong Kong, China
- 2Princess Margaret Hospital, Hong Kong, China
- 3Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
- 4Queen Elizabeth Hospital, Hong Kong, China
- 5Prince of Wales Hospital, Hong Kong, China
- 6The Grantham Hospital, Hong Kong, China
- 7St Paul's Hospital, Hong Kong, China
- 8Pok Oi Hospital, Hong Kong, China
- 9Tuen Mun Hospital, Hong Kong, China
Drug-eluting stents (DES) compared with bare-metal stents (BMS) reduce target vessel revascularization (TVR) rate. Data of DES versus BMS in long-term survival after percutaneous coronary intervention are so far inconclusive. The aim of this retrospective study was to examine the medium-term clinical outcome of DES versus BMS in left main (LM) stenting.
From January 2007 to December 2010, 550 consecutive patients who underwent LM stenting in 8 public hospitals in Hong Kong were recruited for retrospective analysis. Clinical follow-up data were collected up till 30 June 2014.
The age was 68 ± 11 years with male predominance (74%). Diabetes mellitus, hypertension, hypercholesterolemia and smoking history was present in 241 (44%), 359 (65%), 410 (75%) and 244 (44%) patients respectively. Prior myocardial infarction (MI), prior stroke, peripheral vascular disease (PVD) and creatinine>200 mmol/L (CRI) was found in 212 (39%), 62 (11%), 14 (3%), and 28 (5%) patients respectively. An intra-aortic balloon pump was used in 73 (13%) patients and intravascular ultrasonography in 438 (80%) patients. Distal bifurcation disease was present in 406 (74%) patients. The two-stent technique was performed in 145 (26%) patients. The main branch stent size and length was 3.4 ± 0.5 mm and 22 ± 12 mm. High-pressure post-dilatation, and kissing balloon inflation was performed in 474 (86%) and 290 (53%) patients respectively. DES were used in 465 (85%) patients. One year rate of death, nonfatal MI, TVR and probable or definite stent thrombosis (ST) was 7.8%, 6%, 7.8% and 2% respectively. After follow-up for 242 ± 98 weeks, the rate of death, nonfatal MI, TVR, and ST was 19.6%, 9.1%, 11.6% and 3.6% respectively. By cox proportional hazard function analysis, old age, PVD, CRI and use of BMS were independent predictors of medium term all-causes death.
Old age, PVD, and CRI were independent predictors of medium term all-causes death. Compared with BMS, DES prolong survival in patients receiving LM stenting.