Document Detail


Immediate and long-term outcomes of drug-eluting stent implantation for unprotected left main coronary artery disease: comparison with bare-metal stent implantation.
MedLine Citation:
PMID:  18294496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The efficacy and safety of drug-eluting stent (DES) implantation for unprotected left main coronary artery (LMCA) disease remain to be established in different clinical settings. METHODS: Elective DES implantation for unprotected LMCA stenosis was performed in 220 patients at the Fu Wai Hospital, China, from April 2003 to February 2006. Data derived from the latter group were compared with those derived from 224 patients treated with bare-metal stents (BMSs) before March 2003 in a Chinese registry of unprotected LMCA stenting. RESULTS: Compared with the historical BMS control group, the DES group had more multivessel disease and underwent more bifurcation stenting. The inhospital major adverse cardiac events were significantly higher in the DES than in the BMS recipients (4.1% vs 0.9%, P = .030) because of more complex lesions and procedures in the DES group. During the 15-month mean follow-up period, cumulative cardiac death (0.5% vs 4.9%, P = .004), target-vessel revascularization (5.9% vs 11.6%, P = .034), and major adverse cardiac event (9.5% vs 16.5%, P = .029) rates were significantly lower in the DES than in the BMS group. There was no significant difference in clinical efficacy between sirolimus- and paclitaxel-eluting stents. Angiographic follow-up was performed in 46.4% of DES and 45.7% of BMS recipients, respectively; and the binary restenosis rate was significantly lower in the DES versus the BMS control group (16.7% vs 31.4%, P = .014). CONCLUSIONS: Based on this comparison with a historical control, DES implantation for unprotected LMCA appears safe in selected patients and might be more effective in preventing major adverse cardiac events compared with BMS implantation over a mean follow-up period of 15 months.
Authors:
Run-lin Gao; Bo Xu; Ji-lin Chen; Yue-jin Yang; Shu-bin Qiao; Jian-jun Li; Xue-wen Qin; Min Yao; Hai-bo Liu; Yong-jian Wu; Jin-qing Yuan; Jue Chen
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  155     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-25     Completed Date:  2008-03-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  553-61     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical, College, Beijing, China. gaorunlin@263.net
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents, Phytogenic / pharmacology
Blood Vessel Prosthesis Implantation / instrumentation*
China / epidemiology
Coated Materials, Biocompatible*
Coronary Angiography
Coronary Disease / radiography,  surgery*,  ultrasonography
Coronary Restenosis / epidemiology
Female
Follow-Up Studies
Humans
Immunosuppressive Agents / pharmacology
Incidence
Male
Metals*
Middle Aged
Myocardial Revascularization / methods*
Paclitaxel / pharmacology
Retrospective Studies
Sirolimus / pharmacology
Stents*
Time Factors
Treatment Outcome
Ultrasonography, Interventional
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Phytogenic; 0/Coated Materials, Biocompatible; 0/Immunosuppressive Agents; 0/Metals; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus

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


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