| 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. | |
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MedLine Citation:
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PMID: 19246905 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article Date: 2009-02-26 |
Journal Detail:
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Title: Cardiology Volume: 113 ISSN: 1421-9751 ISO Abbreviation: Cardiology Publication Date: 2009 |
Date Detail:
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Created Date: 2009-07-02 Completed Date: 2009-09-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 264-73 Citation Subset: IM |
Copyright Information:
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Copyright 2009 S. Karger AG, Basel. |
Affiliation:
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Cardiological Department, Nanjing First Hospital, Nanjing Medical University, Nanjing, PR China. chmengx@126.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Cardiology. 2009;113(4):260-3
[PMID:
19246904
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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