Document Detail


Long-term follow-up (four years) of unprotected left main coronary artery disease treated with paclitaxel-eluting stents (from the TRUE Registry).
MedLine Citation:
PMID:  20542775     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Limited data are available on the long-term outcome following PCI with paclitaxel-eluting stent (PES) implantation in patients with unprotected left main coronary artery (LMCA). The objective of this study was to evaluate "real world" long-term outcome following paclitaxel-eluting stent (PES) implantation for unprotected LMCA disease in patients enrolled in the TRUE registry.
METHODS AND RESULTS: From March 2003 to October 2004, 93 consecutive patients (81.7% male) underwent PCI for unprotected LMCA disease. Surveillance angiography was performed at 6.8+/-3.3 months follow-up. The target lesion involved the distal LMCA in 68 (73.1%) patients. Double stenting techniques were performed in 46 (67.6%) distal LMCA, of these 50% were stented using the Crush technique. Clinical follow-up was complete in all patients with 85.8% angiographic follow-up rate. In-segment restenosis occurred in 16 (20.3%) patients and was focal in 72.4% of cases and significantly higher in patients with distal LMCA (36.8% vs. 13.6%, p<0.04). At a median follow-up of 1,450 days (IQR 1281-1595), the overall incidence of MACE was 35.5% and the TLR rate was 25.8% and significantly higher in patients with bifurcation stenting (32.3% vs. 8%, p<0.02). The estimated cardiac survival rate at one and four years was 96.7% and 93.3%, respectively. Total mortality rate was 14.1% and cardiac was 6.5%. There was one (1.1%) definite stent thrombosis (ST) and one (1.1%) probable ST.
CONCLUSIONS: Treatment of unprotected LMCA disease with PES, after four years follow-up, appears to be safe and effective with a low rate of cardiac mortality and overall risk of ST. The need for target lesion revascularisation in 25.8% of patients highlights the need for more effective PCI especially in patients with distal LMCA disease.
Authors:
Cosmo Godino; Guido Parodi; Shinichi Furuichi; Azeem Latib; Rossella Barbagallo; Omer Goktekin; Michela Cera; Ralf Mueller; Corrado Tamburino; Eberhard Grube; Carlo Di Mario; Bernard Reimers; Alaide Chieffo; David Antoniucci; Antonio Colombo; Giuseppe M Sangiorgi
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  5     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-06-14     Completed Date:  2010-09-27     Revised Date:  2011-02-22    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  906-16     Citation Subset:  IM    
Affiliation:
San Raffaele Institute, Milan, Italy. cosmogodino@gmail.com <cosmogodino@gmail.com>
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality
Cardiovascular Agents / administration & dosage*
Chi-Square Distribution
Coronary Angiography
Coronary Artery Disease / mortality,  radiography,  therapy*
Coronary Restenosis / etiology
Disease-Free Survival
Drug-Eluting Stents*
Europe / epidemiology
Female
Follow-Up Studies
Hospital Mortality
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Myocardial Infarction / etiology
Paclitaxel / administration & dosage*
Prosthesis Design
Registries
Risk Assessment
Risk Factors
Severity of Illness Index
Thrombosis / etiology
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 33069-62-4/Paclitaxel
Comments/Corrections
Comment In:
EuroIntervention. 2011 Feb;6(7):904-5   [PMID:  21252030 ]

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


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