Resultados a muy largo plazo tras la implantación de stents liberadores de fármacos en la estenosis de arteria coronaria principal izquierda no protegida: experiencia de un centro

Translated title of the contribution: Very long-term outcomes following drug-eluting stent implantation for unprotected left main coronary artery stenosis: A single center experience

Alfonso Ielasi, Azeem Latib, Alaide Chieffo, Kensuke Takagi, Marco Mussardo, Giedrius Davidavicius, Cosmo Godino, Mauro Carlino, Matteo Montorfano, Antonio Colombo

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction and objectives: Encouraging results at long-term follow-up have been reported from non-randomized registries and randomized trials following percutaneous coronary intervention with drug-eluting stent implantation for unprotected left main stenosis. However, information on very long-term (>5-year) outcomes is limited. The aim of this study was to assess the very long-term outcomes (6-years) following drug-eluting stent implantation for left main disease. Methods: All consecutive patients with unprotected left main stenosis electively treated with drug-eluting stent implantation, between March 2002 and May 2005, were analyzed according to the location of the left main lesion (distal bifurcation vs ostial/body). Results: The study included 149 patients: 113 with distal bifurcation and 36 with ostial/body lesion. Triple-vessel disease was significantly higher in the distal than in the ostial/body group (52.2% vs 33.2%, P=.05). At 6-years of follow-up, the cumulative major adverse cardiovascular event rate was 41.6% (45.1% distal vs 30.6% ostial/body, P=0.1), including 18.8% any death (22.1% distal vs 8.3% ostial/body, P=.08), 3.4% myocardial infarction (3.5% distal vs 2.8% ostial/body, P=1), and 15.4% target lesion revascularization (18.6% distal vs 5.6% ostial/body, P=.06). The composite of cardiac death and myocardial infarction was 10.7% (13.3% distal vs 2.8% ostial/body, P=.1) while the definite/probable stent thrombosis rate was 1.4% (all in the distal group). Conclusions: At 6-year clinical follow-up, percutaneous coronary intervention with drug-eluting stent implantation for unprotected left main disease was associated with acceptable rates of cardiac death, myocardial infarction and stent thrombosis. Favorable long-term outcomes in ostial/body lesions compared to distal bifurcation lesions were confirmed at long-term clinical follow-up.

Original languageSpanish
Pages (from-to)24-33
Number of pages10
JournalRevista Espanola de Cardiologia
Volume66
Issue number1
DOIs
Publication statusPublished - Jan 2013

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Drug-Eluting Stents
Coronary Stenosis
Myocardial Infarction
Percutaneous Coronary Intervention
Stents
Pathologic Constriction
Thrombosis
Registries

Keywords

  • Coronary angioplasty
  • Coronary disease
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Resultados a muy largo plazo tras la implantación de stents liberadores de fármacos en la estenosis de arteria coronaria principal izquierda no protegida : experiencia de un centro. / Ielasi, Alfonso; Latib, Azeem; Chieffo, Alaide; Takagi, Kensuke; Mussardo, Marco; Davidavicius, Giedrius; Godino, Cosmo; Carlino, Mauro; Montorfano, Matteo; Colombo, Antonio.

In: Revista Espanola de Cardiologia, Vol. 66, No. 1, 01.2013, p. 24-33.

Research output: Contribution to journalArticle

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title = "Resultados a muy largo plazo tras la implantaci{\'o}n de stents liberadores de f{\'a}rmacos en la estenosis de arteria coronaria principal izquierda no protegida: experiencia de un centro",
abstract = "Introduction and objectives: Encouraging results at long-term follow-up have been reported from non-randomized registries and randomized trials following percutaneous coronary intervention with drug-eluting stent implantation for unprotected left main stenosis. However, information on very long-term (>5-year) outcomes is limited. The aim of this study was to assess the very long-term outcomes (6-years) following drug-eluting stent implantation for left main disease. Methods: All consecutive patients with unprotected left main stenosis electively treated with drug-eluting stent implantation, between March 2002 and May 2005, were analyzed according to the location of the left main lesion (distal bifurcation vs ostial/body). Results: The study included 149 patients: 113 with distal bifurcation and 36 with ostial/body lesion. Triple-vessel disease was significantly higher in the distal than in the ostial/body group (52.2{\%} vs 33.2{\%}, P=.05). At 6-years of follow-up, the cumulative major adverse cardiovascular event rate was 41.6{\%} (45.1{\%} distal vs 30.6{\%} ostial/body, P=0.1), including 18.8{\%} any death (22.1{\%} distal vs 8.3{\%} ostial/body, P=.08), 3.4{\%} myocardial infarction (3.5{\%} distal vs 2.8{\%} ostial/body, P=1), and 15.4{\%} target lesion revascularization (18.6{\%} distal vs 5.6{\%} ostial/body, P=.06). The composite of cardiac death and myocardial infarction was 10.7{\%} (13.3{\%} distal vs 2.8{\%} ostial/body, P=.1) while the definite/probable stent thrombosis rate was 1.4{\%} (all in the distal group). Conclusions: At 6-year clinical follow-up, percutaneous coronary intervention with drug-eluting stent implantation for unprotected left main disease was associated with acceptable rates of cardiac death, myocardial infarction and stent thrombosis. Favorable long-term outcomes in ostial/body lesions compared to distal bifurcation lesions were confirmed at long-term clinical follow-up.",
keywords = "Coronary angioplasty, Coronary disease, Stent",
author = "Alfonso Ielasi and Azeem Latib and Alaide Chieffo and Kensuke Takagi and Marco Mussardo and Giedrius Davidavicius and Cosmo Godino and Mauro Carlino and Matteo Montorfano and Antonio Colombo",
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T2 - experiencia de un centro

AU - Ielasi, Alfonso

AU - Latib, Azeem

AU - Chieffo, Alaide

AU - Takagi, Kensuke

AU - Mussardo, Marco

AU - Davidavicius, Giedrius

AU - Godino, Cosmo

AU - Carlino, Mauro

AU - Montorfano, Matteo

AU - Colombo, Antonio

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N2 - Introduction and objectives: Encouraging results at long-term follow-up have been reported from non-randomized registries and randomized trials following percutaneous coronary intervention with drug-eluting stent implantation for unprotected left main stenosis. However, information on very long-term (>5-year) outcomes is limited. The aim of this study was to assess the very long-term outcomes (6-years) following drug-eluting stent implantation for left main disease. Methods: All consecutive patients with unprotected left main stenosis electively treated with drug-eluting stent implantation, between March 2002 and May 2005, were analyzed according to the location of the left main lesion (distal bifurcation vs ostial/body). Results: The study included 149 patients: 113 with distal bifurcation and 36 with ostial/body lesion. Triple-vessel disease was significantly higher in the distal than in the ostial/body group (52.2% vs 33.2%, P=.05). At 6-years of follow-up, the cumulative major adverse cardiovascular event rate was 41.6% (45.1% distal vs 30.6% ostial/body, P=0.1), including 18.8% any death (22.1% distal vs 8.3% ostial/body, P=.08), 3.4% myocardial infarction (3.5% distal vs 2.8% ostial/body, P=1), and 15.4% target lesion revascularization (18.6% distal vs 5.6% ostial/body, P=.06). The composite of cardiac death and myocardial infarction was 10.7% (13.3% distal vs 2.8% ostial/body, P=.1) while the definite/probable stent thrombosis rate was 1.4% (all in the distal group). Conclusions: At 6-year clinical follow-up, percutaneous coronary intervention with drug-eluting stent implantation for unprotected left main disease was associated with acceptable rates of cardiac death, myocardial infarction and stent thrombosis. Favorable long-term outcomes in ostial/body lesions compared to distal bifurcation lesions were confirmed at long-term clinical follow-up.

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