Early and mid-term results of drug-eluting stent implantation in unprotected left main

Alaide Chieffo, Goran Stankovic, Erminio Bonizzoni, Eleftheria Tsagalou, Ioannis Iakovou, Matteo Montorfano, Flavio Airoldi, Iassen Michev, Massimo Giuseppe Sangiorgi, Mauro Carlino, Giancarlo Vitrella, Antonio Colombo

Research output: Contribution to journalArticle

Abstract

Background-The safety and efficacy of percutaneous coronary intervention in unprotected left main (ULM) coronary arteries are still a matter of debate. Methods and Results-All consecutive patients who had a sirolimus-eluting stent (Cypher, Cordis, Johnson and Johnson Co) or a paclitaxel-eluting stent (Taxus, Boston Scientific) electively implanted in de novo lesions on unprotected left main were analyzed. Patients treated with a drug-eluting stent (DES) were compared with the historical group of consecutive patients treated with bare metal stent (BMS). Eighty-five patients were treated with DES; 64 had BMS implantation. Patients treated with DES had lower ejection fractions (51.1±11% versus 57.4±13%, P=0.002) and were more often diabetics (21.2% versus 10.9%, P=0.12) with more frequent distal left main involvement (81.2% versus 57.8%, P=0.003). Furthermore, in the DES group, smaller vessels (3.33±0.6 versus 3.7±0.7 mm, respectively; P=0.0001) with more lesions (2.94±1.6 versus 2.25±1.3, P=0.004) and vessels (2.03±0.69 versus 1.8±0.72, P=0.05) were treated with longer stents (24.3±12 versus 15.8±8.6 mm, P=0.0001). Despite the higher-risk patients and lesion profiles in the DES group, the incidence of major cardiac events at a 6-month clinical follow-up was lower in the DES than in the BMS group (20.0% versus 35.9%, respectively; P=0.039). Moreover, cardiac deaths occurred in 3 DES patients (3.5%), as compared with 6 (9.3%) in the BMS group (P=0.17). Conclusions-In this early experience with DES in unprotected left main, this procedure appears safe with favorable and improved clinical results as compared with historical control subjects with a BMS. A randomized study comparing surgery appears justified at present.

Original languageEnglish
Pages (from-to)791-795
Number of pages5
JournalCirculation
Volume111
Issue number6
DOIs
Publication statusPublished - Feb 15 2005

Keywords

  • Arteries
  • Revascularization
  • Stents, drug-eluting

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Chieffo, A., Stankovic, G., Bonizzoni, E., Tsagalou, E., Iakovou, I., Montorfano, M., Airoldi, F., Michev, I., Sangiorgi, M. G., Carlino, M., Vitrella, G., & Colombo, A. (2005). Early and mid-term results of drug-eluting stent implantation in unprotected left main. Circulation, 111(6), 791-795. https://doi.org/10.1161/01.CIR.0000155256.88940.F8