TY - JOUR
T1 - Impact of Acute Coronary Syndromes on Two-Year Clinical Outcomes in Patients With Unprotected Left Main Coronary Artery Stenosis Treated With Drug-Eluting Stents
AU - Palmerini, Tullio
AU - Sangiorgi, Diego
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
PY - 2010/1/15
Y1 - 2010/1/15
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.
AB - 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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U2 - 10.1016/j.amjcard.2009.08.666
DO - 10.1016/j.amjcard.2009.08.666
M3 - Article
C2 - 20102914
AN - SCOPUS:73149116254
VL - 105
SP - 174
EP - 178
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 2
ER -