title: Long-term (three-year) outcomes after stenting of unprotected left main coronary artery stenosis in patients with normal left ventricular function.
abstract: The purpose of this study was to analyze long-term follow-up information from patients treated with stenting for unprotected left main coronary artery (LMCA) stenosis. Stenting of unprotected LMCA stenosis is often performed in selected patients, but the long-term safety of this therapy is not yet established. Between January 1995 and September 2000, 270 consecutive patients with unprotected LMCA stenosis and normal left ventricular function who underwent treatment at 4 clinical centers were included in this study. Data were forwarded to the coordinating center using a standard case report form. The procedural success rate was 98.9%. There were no deaths, 3 stent thromboses, and 3 Q-wave myocardial infarctions during the hospitalization. Angiographic follow-up was performed in 237 patients (follow-up rate 87.8%), and the restenosis rate was 21.1%. The reference size was an independent predictor of binary restenosis (odds ratio 0.543, 95% confidence interval 0.308 to 0.957, p = 0.03). During the follow-up period (32.3 +/- 18.5 months), there were 20 deaths (8 cardiac, 12 noncardiac) and 5 nonfatal myocardial infarctions. Target and new lesion revascularizations were required in 45 (16.7%) and 31 (11.5%) patients, respectively. The cumulative probabilities free from major adverse cardiac events were 81.9 +/- 2.4%, 78.4 +/- 2.6%, and 77.7 +/- 2.7%, respectively, at 1, 2, and 3 years. Combined coronary artery disease and postprocedural minimal luminal diameter were the significant predictors of major adverse cardiac events. Thus, the long-term prognosis of patients after stenting of unprotected LMCA stenosis was favorable in selected patients with normal left ventricular function.
authors.affiliation: Cardiac Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. sjpark@amc.seoul.kr
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Myeong-K i
authors.initials: MK
authors.lastname: Hong
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Jang
authors.forename: Eak-Kyun
authors.initials: EK
authors.lastname: Shin
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Takashi
authors.initials: T
authors.lastname: Tamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Nobuyoshi
mesh_terms: D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015607:Stents; D016896:Treatment Outcome; D016277:Ventricular Function, Left