| Treatment of unprotected left main disease with drug-eluting stents in patients at high risk for coronary artery bypass grafting. | |
| | |
MedLine Citation:
|
PMID: 17574165 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Percutaneous coronary intervention (PCI) for high-grade stenosis of the left main coronary artery with bare-metal stents has been limited by restenosis, and most patients are managed with coronary artery bypass grafting (CABG). Recently, drug-eluting stents (DES) have reduced instent restenosis after PCI, but their role in the treatment of left main disease remains unclear. AIMS: The aim of this study was to determine the outcomes after utilizing DES to treat left main disease. METHODS: Twenty consecutive symptomatic patients with >50% angiographic stenosis of the left main coronary artery with no prior history of CABG ["unprotected left main" (ULM)] underwent PCI with DES. Patients were divided into two groups based on the presence (Group A, n=5) or absence (Group B, n=15) of preprocedural cardiogenic shock. At follow up (median, 14 months), cumulative major adverse cardiac events (MACE-death, myocardial infarction, or target vessel revascularization) were determined. RESULTS: Sixteen (80%) of 20 patients were at high risk for CABG because of comorbidity, advanced age, or cardiogenic shock. Procedural success was 100% (20/20). Three of five patients in Group A (60%) died in hospital and the two surviving patients experienced no MACE at follow up. In Group B (n=15), there was no in-hospital MACE, but one patient died suddenly 8 weeks postprocedure [cumulative MACE of 7% (1/15)]. CONCLUSIONS: Our study demonstrates the feasibility of ULM treatment with DES with acceptable medium-term outcomes. While CABG remains the best form of revascularization for the majority of patients with ULM, DES should be considered in those who are at high risk. |
| | |
Authors:
|
Peter Barlis; Mark Horrigan; Safari Elis; Robert Chan; Michael Wong; Omar Farouque; George Proimos; Andrew E Ajani; David J Clark |
Related Documents
:
|
16350555 - Acute coronary syndromes without persistent st-segment elevation: advances in surgical ... 17211295 - Predictors of in-hospital morbidity and mortality in patients with coronary artery dise... 16362855 - Fractional flow reserve assessment to determine the indications for myocardial revascul... 11093485 - Off-pump versus on-pump coronary bypass in high-risk subgroups. 15532725 - At2 receptor and apoptosis during at1 receptor blockade in reperfused myocardial infarc... 15548885 - Outcome of right ventricular bifocal pacing in patients with permanent atrial fibrillat... |
Publication Detail:
|
Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
|
Title: Cardiovascular revascularization medicine : including molecular interventions Volume: 8 ISSN: 1553-8389 ISO Abbreviation: - Publication Date: 2007 Apr-Jun |
Date Detail:
|
Created Date: 2007-06-18 Completed Date: 2007-09-27 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101238551 Medline TA: Cardiovasc Revasc Med Country: United States |
Other Details:
|
Languages: eng Pagination: 84-9 Citation Subset: IM |
Affiliation:
|
Department of Cardiology, Austin Hospital, Melbourne, Victoria 3084, Australia. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Angioplasty, Transluminal, Percutaneous Coronary / adverse effects, instrumentation* Cardiovascular Agents / administration & dosage* Cardiovascular Diseases / etiology, mortality Coronary Angiography Coronary Artery Bypass / adverse effects* Coronary Stenosis / mortality, radiography, surgery, therapy* Feasibility Studies Female Follow-Up Studies Humans Male Middle Aged Patient Selection* Prospective Studies Prosthesis Design Research Design Risk Assessment Severity of Illness Index Shock, Cardiogenic / etiology, mortality Stents* Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Cardiovascular Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The European Regulation on medicines for paediatric use.
Next Document: Revascularization algorithm in acute STEMI should take into account age.