TY - JOUR
T1 - Comparison of bare-metal stent and drug-eluting stent for the treatment of patients undergoing percutaneous coronary intervention for unprotected left main coronary artery disease - Long-term result from a single center experience
AU - Lai, Chih Hung
AU - Lee, Wen Lieng
AU - Sung, Shih Hsien
AU - Hsu, Pai Feng
AU - Chen, Ying Hwa
AU - Chan, Wan Leong
AU - Lin, Shing Jong
AU - Lu, Tse Min
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Background: Percutaneous coronary intervention (PCI) has become an alternative treatment for left main (LM) coronary artery disease. The aim of our study was to compare long-term clinical outcomes of patients undergoing unprotected LMPCI with bare-metal stent (BMS) or drug-eluting stent (DES) in a high-risk population. Methods and Results: We enrolled 223 consecutive patients with unprotected LM coronary artery disease undergoing PCI (mean age: 71.1±11.2 years, 187 male), including 94 patients receiving BMS and 129 patients receiving DES. The patients receiving DES had a significantly higher SYNTAX score (p = 0.05). During the mean follow-up period of 2.5 years, there were 31 cardiovascular deaths (BMS: 21 cases, DES: 10 cases, p = 0.04 by log-rank test), 56 major adverse cardiovascular events (MACE, including cardiovascular death, non-fatal myocardial infarction (MI) and clinical-driven target lesion revascularization; BMS: 33 cases, DES: 23 cases, p = 0.03 by log-rank test) and 6 cases with definite/probable stent thrombosis (BMS: 5 cases, DES: 1 cases, p = 0.09). Inmultivariate Cox analysis, the use of DES was identified as an independent protective factor against cardiovascular death [hazard ratio (HR) = 0.34, 95% confidence interval (Cl) = 0.15-0.79, p = 0.01] and MACE (HR = 0.50, 95% CI = 0.28-0.88, p = 0.02). The clinical outcome analyses in propensity-scorematched the cohort (87 matched pair of patients receiving BMS and DES) and yielded similar results. Conclusions: In the general practice among a high-risk population undergoing unprotected LMPCI, the use of DES appeared to be beneficial in reducing the risk of long-term cardiovascular death and MACE.
AB - Background: Percutaneous coronary intervention (PCI) has become an alternative treatment for left main (LM) coronary artery disease. The aim of our study was to compare long-term clinical outcomes of patients undergoing unprotected LMPCI with bare-metal stent (BMS) or drug-eluting stent (DES) in a high-risk population. Methods and Results: We enrolled 223 consecutive patients with unprotected LM coronary artery disease undergoing PCI (mean age: 71.1±11.2 years, 187 male), including 94 patients receiving BMS and 129 patients receiving DES. The patients receiving DES had a significantly higher SYNTAX score (p = 0.05). During the mean follow-up period of 2.5 years, there were 31 cardiovascular deaths (BMS: 21 cases, DES: 10 cases, p = 0.04 by log-rank test), 56 major adverse cardiovascular events (MACE, including cardiovascular death, non-fatal myocardial infarction (MI) and clinical-driven target lesion revascularization; BMS: 33 cases, DES: 23 cases, p = 0.03 by log-rank test) and 6 cases with definite/probable stent thrombosis (BMS: 5 cases, DES: 1 cases, p = 0.09). Inmultivariate Cox analysis, the use of DES was identified as an independent protective factor against cardiovascular death [hazard ratio (HR) = 0.34, 95% confidence interval (Cl) = 0.15-0.79, p = 0.01] and MACE (HR = 0.50, 95% CI = 0.28-0.88, p = 0.02). The clinical outcome analyses in propensity-scorematched the cohort (87 matched pair of patients receiving BMS and DES) and yielded similar results. Conclusions: In the general practice among a high-risk population undergoing unprotected LMPCI, the use of DES appeared to be beneficial in reducing the risk of long-term cardiovascular death and MACE.
KW - Bare-mental stent
KW - Drug-eluting stent
KW - Left main coronary artery disease
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=84942064565&partnerID=8YFLogxK
U2 - 10.6515/ACS20140630G
DO - 10.6515/ACS20140630G
M3 - Article
AN - SCOPUS:84942064565
SN - 1011-6842
VL - 31
SP - 381
EP - 389
JO - Acta Cardiologica Sinica
JF - Acta Cardiologica Sinica
IS - 5
ER -