Document Detail


Long-term clinical and angiographic outcomes of treatment of unprotected left main coronary artery stenosis with sirolimus-eluting stents.
MedLine Citation:
PMID:  17659923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Favorable early results of percutaneous drug-eluting stents in unprotected left main (LM) disease are available, but outcome data beyond 6 to 10 months are lacking. We evaluated the long-term results of sirolimus-eluting stents (SESs) in patients with LM disease. From November 2002 to December 2004, consecutive patients with LM disease, without contraindications to double antiplatelet therapy and undergoing SES implantation, were enrolled prospectively. The primary end point of the study was occurrence of major adverse cardiovascular events. In total 85 patients were treated with 118 SES and followed for 595 +/- 230 days. Event-free survival rates at 1 year and 2 years were 85.5% and 78.6%, respectively. Only 2 deaths occurred overall (2.4%), the first in-hospital in a very high-risk patient according to the European System for Cardiac Operative Risk Evaluation and the second in a patient with severe systolic dysfunction already at the index procedure). Myocardial infarction was adjudicated in 3 patients (3.6%), 2 occurring periprocedurally and 1 during follow-up for a de novo nontarget lesion. There were 7 (10.8%) target lesion revascularizations at 24 months, with all but 1 percutaneous and in a subject with bifurcation LM disease at baseline. At 9-month angiography, late loss was 0.15 +/- 0.81 mm and restenosis rate was 8.2%. An increased incidence of adverse events was noted in patients undergoing SES after dilation with extremely oversized balloons. No case of stent thrombosis was reported. In conclusion, this single-center experience suggests that percutaneous use of SESs to treat LM disease in unselected high-risk patients is safe and effective even 1 year after implantation.
Authors:
Imad Sheiban; Emanuele Meliga; Claudio Moretti; Giuseppe G L Biondi-Zoccai; Giuseppe Rosano; Filippo Sciuto; Walter Grosso Marra; Pierluigi Omedè; Argyrios Gerasimou; Gian Paolo Trevi
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Publication Detail:
Type:  Journal Article     Date:  2007-06-13
Journal Detail:
Title:  The American journal of cardiology     Volume:  100     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-30     Completed Date:  2007-10-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  431-5     Citation Subset:  AIM; IM    
Affiliation:
Interventional Cardiology, Division of Cardiology, University of Turin, Turin, Italy. isheiban@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography*
Coronary Stenosis / radiography,  therapy*
Disease-Free Survival
Female
Humans
Male
Sirolimus*
Stents*
Chemical
Reg. No./Substance:
53123-88-9/Sirolimus

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


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