Impact of Acute Coronary Syndromes on Two-Year Clinical Outcomes in Patients With Unprotected Left Main Coronary Artery Stenosis Treated With Drug-Eluting Stents

Tullio Palmerini, Diego Sangiorgi, Antonio Marzocchi, Corrado Tamburino, Imad Sheiban, Massimo Margheri, Giuseppe Vecchi, Giuseppe Sangiorgi, Nicoletta Franco, Antonio Bartorelli, Carlo Briguori, Luigi Vignali, Francesco Di Pede, Angelo Ramondo, Massimo Medda, Marco De Carlo, Leonardo Bolognese, Alberto Benassi, Cataldo Palmieri, Vincenzo FilipponeGiulia Lauria, Stefano De Servi

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Abstract

In this study we investigated the impact of acute coronary syndromes (ACSs) on clinical outcomes in patients with unprotected left main coronary artery (ULMCA) stenosis treated with drug-eluting stents (DESs). In this multicenter, retrospective, observational study we enrolled 1,101 patients with ULMCA stenosis treated with DESs. Six hundred eleven patients presented with ACS and 490 had stable coronary artery disease. ACS was defined as the presence of unstable angina or non-ST-segment elevation myocardial infarction (MI). During 2-year follow-up, the adjusted hazard ratio of cardiac mortality and MI of patients with ACS versus stable patients was 2.42 (95% confidence interval 1.37 to 4.28, p = 0.002). We observed a stepwise risk increase, namely patients with stable coronary disease had the lowest risk, patients with unstable angina an intermediate risk, and patients with non-ST-segment elevation MI the highest risk. The increased risk of cardiac mortality and MI of patients with ACS was concentrated in the first year after DES implantation. In conclusion, patients with ULMCA stenosis and ACS treated with DESs have an increased risk of cardiac mortality and MI during the first year after the intervention compared to stable patients.

Original languageEnglish
Pages (from-to)174-178
Number of pages5
JournalThe American Journal of Cardiology
Volume105
Issue number2
DOIs
Publication statusPublished - Jan 15 2010

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Drug-Eluting Stents
Coronary Stenosis
Acute Coronary Syndrome
Myocardial Infarction
Unstable Angina
Mortality
Observational Studies
Coronary Disease
Coronary Artery Disease
Retrospective Studies
Confidence Intervals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of Acute Coronary Syndromes on Two-Year Clinical Outcomes in Patients With Unprotected Left Main Coronary Artery Stenosis Treated With Drug-Eluting Stents. / Palmerini, Tullio; Sangiorgi, Diego; Marzocchi, Antonio; Tamburino, Corrado; Sheiban, Imad; Margheri, Massimo; Vecchi, Giuseppe; Sangiorgi, Giuseppe; Franco, Nicoletta; Bartorelli, Antonio; Briguori, Carlo; Vignali, Luigi; Di Pede, Francesco; Ramondo, Angelo; Medda, Massimo; De Carlo, Marco; Bolognese, Leonardo; Benassi, Alberto; Palmieri, Cataldo; Filippone, Vincenzo; Lauria, Giulia; De Servi, Stefano.

In: The American Journal of Cardiology, Vol. 105, No. 2, 15.01.2010, p. 174-178.

Research output: Contribution to journalArticle

Palmerini, T, Sangiorgi, D, Marzocchi, A, Tamburino, C, Sheiban, I, Margheri, M, Vecchi, G, Sangiorgi, G, Franco, N, Bartorelli, A, Briguori, C, Vignali, L, Di Pede, F, Ramondo, A, Medda, M, De Carlo, M, Bolognese, L, Benassi, A, Palmieri, C, Filippone, V, Lauria, G & De Servi, S 2010, 'Impact of Acute Coronary Syndromes on Two-Year Clinical Outcomes in Patients With Unprotected Left Main Coronary Artery Stenosis Treated With Drug-Eluting Stents', The American Journal of Cardiology, vol. 105, no. 2, pp. 174-178. https://doi.org/10.1016/j.amjcard.2009.08.666
Palmerini, Tullio ; Sangiorgi, Diego ; Marzocchi, Antonio ; Tamburino, Corrado ; Sheiban, Imad ; Margheri, Massimo ; Vecchi, Giuseppe ; Sangiorgi, Giuseppe ; Franco, Nicoletta ; Bartorelli, Antonio ; Briguori, Carlo ; Vignali, Luigi ; Di Pede, Francesco ; Ramondo, Angelo ; Medda, Massimo ; De Carlo, Marco ; Bolognese, Leonardo ; Benassi, Alberto ; Palmieri, Cataldo ; Filippone, Vincenzo ; Lauria, Giulia ; De Servi, Stefano. / Impact of Acute Coronary Syndromes on Two-Year Clinical Outcomes in Patients With Unprotected Left Main Coronary Artery Stenosis Treated With Drug-Eluting Stents. In: The American Journal of Cardiology. 2010 ; Vol. 105, No. 2. pp. 174-178.
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AU - Marzocchi, Antonio

AU - Tamburino, Corrado

AU - Sheiban, Imad

AU - Margheri, Massimo

AU - Vecchi, Giuseppe

AU - Sangiorgi, Giuseppe

AU - Franco, Nicoletta

AU - Bartorelli, Antonio

AU - Briguori, Carlo

AU - Vignali, Luigi

AU - Di Pede, Francesco

AU - Ramondo, Angelo

AU - Medda, Massimo

AU - De Carlo, Marco

AU - Bolognese, Leonardo

AU - Benassi, Alberto

AU - Palmieri, Cataldo

AU - Filippone, Vincenzo

AU - Lauria, Giulia

AU - De Servi, Stefano

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N2 - In this study we investigated the impact of acute coronary syndromes (ACSs) on clinical outcomes in patients with unprotected left main coronary artery (ULMCA) stenosis treated with drug-eluting stents (DESs). In this multicenter, retrospective, observational study we enrolled 1,101 patients with ULMCA stenosis treated with DESs. Six hundred eleven patients presented with ACS and 490 had stable coronary artery disease. ACS was defined as the presence of unstable angina or non-ST-segment elevation myocardial infarction (MI). During 2-year follow-up, the adjusted hazard ratio of cardiac mortality and MI of patients with ACS versus stable patients was 2.42 (95% confidence interval 1.37 to 4.28, p = 0.002). We observed a stepwise risk increase, namely patients with stable coronary disease had the lowest risk, patients with unstable angina an intermediate risk, and patients with non-ST-segment elevation MI the highest risk. The increased risk of cardiac mortality and MI of patients with ACS was concentrated in the first year after DES implantation. In conclusion, patients with ULMCA stenosis and ACS treated with DESs have an increased risk of cardiac mortality and MI during the first year after the intervention compared to stable patients.

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