Document Detail


Clinical outcome after management of unprotected left main in-stent restenosis after bare metal or drug-eluting stents.
MedLine Citation:
PMID:  20497666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Implantation of either bare metal stent (BMS) or drug-eluting stent (DES) has been used in every day practice for patients with unprotected left main stenosis (UPLMS). There are still a lack of data regarding the subsequent results of UPLMS in-stent restenosis (ISR). The present study aimed at determining the clinical outcome of UPLMS ISR patients after implantation of either BMS or DES. METHODS: Patients with UPLMS ISR after stenting were included. The primary endpoint was the cumulative major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). RESULTS: UPLMS ISR rate was 14.8% (n = 73, 15.7% after BMS, 14.5% for DES) after average of (3.89 +/- 2.01) years (range from 1 to 10.5 years) follow-up. Angiographic follow-up between 6 - 8 months was available in 85.3%. Of these, repeat percutaneous coronary intervention (PCI) was used in 62 (84.9%) patients, with medicine only in 9 (12.4%) and coronary artery bypass graft (CABG) in 2 (2.7%). Most repeat PCI patients were with unstable angina (87.0%), and had decreased left ventricular ejection fraction ((42.58 +/- 5.12)%), fewer focal/ostial left circumflex branch (LCX) lesions, in relative to medicine only group. After (31.9 +/- 23.3) months, the MACE, MI, TVR and cardiac death were 31.5%, 1.4%, 24.1% and 8.2%, respectively. Definite and possible stent thrombosis occurred in 1 (1.4%) patient. CONCLUSIONS: Medical therapy for asymptomatic isolated ostial LCX was safe. Repeat PCI for UPLMS ISR was associated with acceptable early and short-term clinical outcome. Further study was needed to elucidate the role of CABG in treating UPLMS ISR.
Authors:
Shao-Liang Chen; Bo Xu; Gary Mintz; Fei Ye; Jun-Jie Zhang; Jing Kan; Xue-Wen Sun; Ai-Ping Zhang; Jin-Guo Chen; Jun Qian; Tak W Kwan
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chinese medical journal     Volume:  123     ISSN:  0366-6999     ISO Abbreviation:  Chin. Med. J.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513795     Medline TA:  Chin Med J (Engl)     Country:  China    
Other Details:
Languages:  eng     Pagination:  794-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China. chmengx@126.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Angiography
Coronary Restenosis / pathology,  therapy*
Drug-Eluting Stents / adverse effects*
Female
Humans
Male
Middle Aged
Stents / adverse effects*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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