Ostial and midshaft lesions vs. bifurcation lesions in 1111 patients with unprotected left main coronary artery stenosis treated with drug-eluting stents: Results of the survey from the Italian Society of Invasive Cardiology

Tullio Palmerini, Diego Sangiorgi, Antonio Marzocchi, Corrado Tamburino, Imad Sheiban, Massimo Margheri, Giuseppe Vecchi, Giuseppe Sangiorgi, Michele Ruffini, Antonio L. Bartorelli, Carlo Briguori, Luigi Vignali, Francesco Di Pede, Angelo Ramondo, Luigi Inglese, Marco De Carlo, Leonardo Bolognese, Alberto Benassi, Cataldo Palmieri, Vincenzo FilipponeFabio Barlocco, Giulia Lauria, Stefano De Servi

Research output: Contribution to journalArticle

Abstract

Aims In this study, we compared the cumulative risk of major adverse cardiac events (MACE) of patients with distal unprotected left main coronary artery (ULMCA) stenosis with those of patients with ostial and midshaft lesions treated with drug-eluting stent (DES).Methods and resultsThe survey promoted by the Italian Society of Invasive Cardiology on ULMCA stenosis was an observational study involving 19 high-volume Italian centres. We enrolled 1111 patients with ULMCA stenosis treated with DES. Major adverse cardiac events were defined as death, myocardial infarction, and target lesion revascularization. Three hundred and thirty-four patients had ostial or midshaft lesions (group 1) and 777 bifurcations (group 2). The adjusted hazards ratio of the risk of 2 year MACE of patients in group 2 vs. patients in group 1 was 1.50 (P = 0.024). However, we observed that there was a significant difference between patients with bifurcations treated with two stents and those in group 1 (P = 0.001), but not between patients with bifurcations treated with one stent and those in group 1 (P = 0.38).ConclusionPatients with bifurcations have a worse outcome than patients with ostial and midshaft lesions. However, the technique used to treat bifurcations has a significant impact on clinical outcomes.

Original languageEnglish
Pages (from-to)2087-2094
Number of pages8
JournalEuropean Heart Journal
Volume30
Issue number17
DOIs
Publication statusPublished - Sep 2009

Keywords

  • Bifurcations
  • Left main
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Palmerini, T., Sangiorgi, D., Marzocchi, A., Tamburino, C., Sheiban, I., Margheri, M., Vecchi, G., Sangiorgi, G., Ruffini, M., Bartorelli, A. L., Briguori, C., Vignali, L., Di Pede, F., Ramondo, A., Inglese, L., De Carlo, M., Bolognese, L., Benassi, A., Palmieri, C., ... De Servi, S. (2009). Ostial and midshaft lesions vs. bifurcation lesions in 1111 patients with unprotected left main coronary artery stenosis treated with drug-eluting stents: Results of the survey from the Italian Society of Invasive Cardiology. European Heart Journal, 30(17), 2087-2094. https://doi.org/10.1093/eurheartj/ehp223