Background:
Long-term outcome of drug-eluting stent (DES) implantation for unprotected left main coronary artery stenosis has not been evaluated in detail.
Methods:
This study included 226 patients with de novo coronary lesions at the unprotected left main coronary artery (ULMCA) who were electively treated with DES and eligible for 2-year follow-up. The outcomes of these patients were compared with those of 200 patients treated with bare-metal stent (BMS) in the preceding years using log-rank test. Cox proportional hazard regression analyses were performed to correct for independent predictors of adverse outcomes between the two groups.
Results:
The DES patients were older, had more history of hypertension and diabetes mellitus, had more involvement of right coronary artery and three vessel stenoses, and were treated with more stents and longer stented length than the BMS patients. On the other hand, debulking atherectomy were more frequently used in the BMS patients. Two-year outcomes with adjusted hazard ratios are presented in the table
.
Conclusions:
For ULMCA stenosis, the superiority of DES in reducing target lesion revascularization (TLR) rate compared with BMS was continuously present up to 2 years. Furthermore, DES had a trend towards lower incidences of death, cardiac death, and stent thrombosis compared with BMS.
Favorable Long-Term Outcome After Drug-Eluting Stent Implantation in Nonbifurcation Lesions That Involve Unprotected Left Main Coronary Artery
