TY - JOUR
T1 - Ostial and midshaft lesions vs. bifurcation lesions in 1111 patients with unprotected left main coronary artery stenosis treated with drug-eluting stents
T2 - Results of the survey from the Italian Society of Invasive Cardiology
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 - Ruffini, Michele
AU - Bartorelli, Antonio L.
AU - Briguori, Carlo
AU - Vignali, Luigi
AU - Di Pede, Francesco
AU - Ramondo, Angelo
AU - Inglese, Luigi
AU - De Carlo, Marco
AU - Bolognese, Leonardo
AU - Benassi, Alberto
AU - Palmieri, Cataldo
AU - Filippone, Vincenzo
AU - Barlocco, Fabio
AU - Lauria, Giulia
AU - De Servi, Stefano
PY - 2009/9
Y1 - 2009/9
N2 - 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.
AB - 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.
KW - Bifurcations
KW - Left main
KW - Stents
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U2 - 10.1093/eurheartj/ehp223
DO - 10.1093/eurheartj/ehp223
M3 - Article
C2 - 19508996
AN - SCOPUS:70049112142
VL - 30
SP - 2087
EP - 2094
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 17
ER -