Document Detail


Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents.
MedLine Citation:
PMID:  19620506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Limited information is available on long-term outcomes for patients with unprotected left main coronary artery disease who received drug-eluting stents (DES). METHODS AND RESULTS: In the multicenter registry evaluating outcomes among patients with unprotected left main coronary artery stenosis undergoing stenting with either bare metal stents (BMS) or DES, 1217 consecutive patients were divided into 2 groups: 353 who received only BMS and 864 who received at least 1 DES. The 3-year outcomes were compared by use of the adjustment of inverse-probability-of-treatment-weighted method. Patients receiving DES were older and had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and multivessel disease. In the overall population, with the use of DES, the 3-year adjusted risk of death (8.0% versus 9.5%; hazard ratio, 0.71; 95% confidence interval, 0.36 to 1.40; P=0.976) or death or myocardial infarction (14.3% versus 14.9%; hazard ratio, 0.83; 95% confidence interval, 0.49 to 1.40; P=0.479) was similar compared with BMS. However, the risk of target lesion revascularization was significantly lower with the use of DES than BMS (5.4% versus 12.1%; hazard ratio, 0.40; 95% confidence interval, 0.22 to 0.73; P=0.003). When patients were classified according to lesion location, DES was still associated with lower risk of target lesion revascularization in patients with bifurcation (6.9% versus 16.3%; hazard ratio, 0.38; 95% confidence interval, 0.18 to 0.78; P=0.009) or nonbifurcation (3.4% versus 10.3%; hazard ratio, 0.39; 95% confidence interval, 0.17 to 0.88; P=0.024) lesions with a comparable risk of death or myocardial infarction. CONCLUSIONS: Compared with BMS, DES was associated with a reduction in the need for repeat revascularization without increasing the risk of death or myocardial infarction for patients with unprotected left main coronary artery stenosis.
Authors:
Young-Hak Kim; Duk-Woo Park; Seung-Whan Lee; Sung-Cheol Yun; Cheol Whan Lee; Myeong-Ki Hong; Seong-Wook Park; Ki Bae Seung; Hyeon-Cheol Gwon; Myung-Ho Jeong; Yangsoo Jang; Hyo-Soo Kim; In-Whan Seong; Hun Sik Park; Taehoon Ahn; In-Ho Chae; Seung-Jea Tahk; Wook-Sung Chung; Seung-Jung Park;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-07-20
Journal Detail:
Title:  Circulation     Volume:  120     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-04     Completed Date:  2009-08-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  400-7     Citation Subset:  AIM; IM    
Affiliation:
Asan Medical Center, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / statistics & numerical data
Coronary Restenosis / mortality*
Coronary Stenosis / mortality*,  therapy*
Diabetic Angiopathies / epidemiology
Drug-Eluting Stents / statistics & numerical data*
Female
Humans
Hyperlipidemias / epidemiology
Hypertension / epidemiology
Incidence
Kaplan-Meiers Estimate
Male
Metals
Middle Aged
Myocardial Infarction / mortality*
Prevalence
Recurrence / prevention & control
Registries / statistics & numerical data
Risk Factors
Safety
Chemical
Reg. No./Substance:
0/Metals

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


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