Document Detail


Sirolimus-eluting stent implantation for treatment of proximal left anterior descending coronary artery lesions: long-term outcome and predictors of adverse cardiac events.
MedLine Citation:
PMID:  17722041     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Acute and long-term results after sirolimus-eluting stent (SES) implantation of proximal left anterior descending coronary artery (LAD) disease were evaluated. BACKGROUND: Although SES has been used increasingly for the treatment of LAD disease, data regarding their safety and efficacy in a real-world population are limited. METHODS: We investigate the short- and long-term results in 966 patients who underwent SES implantation for stenosis of proximal LAD. RESULTS: The procedural success rate was 97.6%, and procedural non-Q-wave myocardial infarction (MI) rate was 14.5%. In-hospital major complications occurred in five patients (0.5%), including three deaths and two Q-wave MIs. During follow-up (20.4 +/- 8.9 months), there were 16 deaths (1.7%; 10 cardiac, 6 noncardiac), 2 Q-wave MIs, and 22 target lesion revascularizations (2.3%). Late stent thrombosis occurred in two patients (0.2%), 14 and 23 months after the procedure. The event-free survival rates for cardiac death/Q-wave MI were 98.6% +/- 0.4% at 1 year and 97.8% +/- 0.6% at 2 years. The cumulative probabilities of survival without major adverse cardiac events (MACE) were 96.7% +/- 0.6% at 1 year and 95.4% +/- 0.8% at 2 years. In multivariate analysis, stented length (HR 1.04, 95%CI 1.01-1.07, P = 0.009) and infarct-related artery (HR 5.18, 95%CI 1.09-24.64, P = 0.039) were independently related to cardiac death/Q-wave MI. In addition, stented length (HR 1.04, 95%CI 1.02-1.06, P < 0.001) and left ventricular dysfunction (HR 2.66, 95%CI 1.07-6.63, P = 0.036) were significant independent predictors of MACE. CONCLUSIONS: SES implantation for proximal LAD disease appears safe and effective in a real-world population, and the independent predictors of MACE included stented length and left ventricular dysfunction.
Authors:
Cheol Whan Lee; Chong-Hiok Tan; Jon Suh; Se-Whan Lee; Duk-Woo Park; Seung-Whan Lee; Young-Hak Kim; Myeong-Ki Hong; Jae-Joong Kim; Seong-Wook Park; Seung-Jung Park
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  70     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-03     Completed Date:  2007-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  368-73     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
Affiliation:
Department of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Vessel Prosthesis Implantation / instrumentation*
Coated Materials, Biocompatible*
Coronary Angiography
Coronary Disease / radiography,  surgery*
Electrocardiography
Female
Follow-Up Studies
Humans
Immunosuppressive Agents / pharmacology*
Male
Middle Aged
Myocardial Revascularization / methods*
Postoperative Complications
Prognosis
Retrospective Studies
Sirolimus / pharmacology*
Stents*
Time Factors
Chemical
Reg. No./Substance:
0/Coated Materials, Biocompatible; 0/Immunosuppressive Agents; 53123-88-9/Sirolimus

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


Previous Document:  Thoracic radiotherapy in patients with lymphoma and restenosis after coronary stent placement.
Next Document:  Anti-platelet and anti-thrombotic approaches in patients undergoing percutaneous coronary interventi...