Document Detail


Distal left main coronary bifurcation lesions predict worse outcome in patients undergoing percutaneous implantation of drug-eluting stents: results from the Drug-Eluting Stent for the Treatment of Left Main Disease (DISTAL) Study.
MedLine Citation:
PMID:  19246905     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We investigated the clinical outcome of stenting of unprotected left main coronary artery (LMCA). METHODS: We studied 164 patients with nonbifurcated LMCA lesions (group A) and 96 patients with distal bifurcated lesions (group B). RESULTS: Clinical follow-up was available in 100%. Angiographic follow-up was 87.3% in group A and 86% in group B (p = 0.922). There were significant differences in major adverse cardiac events at 1 (p = 0.014) and 2 years (p = 0.002) between group B (19.8%, 25.0%) and group A (9.1%, 10.4%), mainly due to increased target-vessel revascularization (16.7, 21.9% in group B vs. 6.1, 7.3% in group A, p = 0.006 and 0.001, respectively). The double-stent technique was associated with worse outcomes at 1 year in group B compared to group A. Bifurcation lesions (HR 3.42, 95% CI 1.34-5.61, p = 0.001), diabetes (HR 2.68, 95% CI 2.01-12.11, p = 0.015), three-vessel disease (HR 0.83, 95% CI 0.27-0.96, p = 0.001), incomplete revascularization (HR 0.15, 95% CI 0.11-0.35, p = 0.001) and stent diameter (HR 5.05, 95% CI 2.71-10.01, p = 0.03) were the independent factors of major adverse cardiac events in the whole patient cohort. CONCLUSION: Stenting unprotected distal bifurcated LMCA was associated with unfavorable results when compared to stenting other LMCA lesions.
Authors:
Shao-Liang Chen; Fei Ye; Jun-jie Zhang; Zhi-zhong Liu; Song Lin; Zhong-Sheng Zhu; Xue-wen Sun; Feng Li; Ai-ping Zhang; Jin-guo Chen; Qing-jiong Ji; Jun Qian; Feng Chen; Tak W Kwan
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Publication Detail:
Type:  Journal Article     Date:  2009-02-26
Journal Detail:
Title:  Cardiology     Volume:  113     ISSN:  1421-9751     ISO Abbreviation:  Cardiology     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-02     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  264-73     Citation Subset:  IM    
Copyright Information:
Copyright 2009 S. Karger AG, Basel.
Affiliation:
Cardiological Department, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China. chmengx@126.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Coronary Angiography*
Coronary Artery Disease / epidemiology,  radiography*,  therapy*
Disease-Free Survival
Drug-Eluting Stents / adverse effects*
Female
Follow-Up Studies
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Predictive Value of Tests
Prevalence
Proportional Hazards Models
Registries
Risk Factors
Stroke Volume
Treatment Failure
Treatment Outcome
Comments/Corrections
Comment In:
Cardiology. 2009;113(4):260-3   [PMID:  19246904 ]

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