[The immediate and long-term prognosis following unprotected left main coronary artery stenting in Chinese--Chinese Registry of Unprotected Left Main Coronary Artery Stenting (CHANCE Study)].
OBJECTIVE
To evaluate the immediate and long-term outcomes of unprotected left main coronary artery (LMCA) stenting in Chinese patients and to approach the factors affecting the outcomes.


METHODS
This was a multicenter retrospective registry study. From May 1997 to March 2003 all patients in 23 hospitals undergone elective unprotected LMCA stenting with bare metal stents were enrolled into the registry. All patients enrolled were filled in a Case Report Form.


RESULTS
224 patients were enrolled into the registry, including 166 male (74.1%) and 58 female (25.9%), with mean age of 60.1 +/- 12.0 (22 - 88) years. There were 53 cases (23.7%) with prior myocardial infarction (MI) and 45 cases (20.1%) with diabetes mellitus. Isolated LMCA stenosis was in 126 cases (56.2%) and combined with multivessel disease in 98 cases (43.8%). Mean left ventricular EF was 63.9% +/- 12.3%. Stents were successfully implanted into LMCA in 223 cases (99.6%) and into non-LMCA in 91 cases (92.9%). In-hospital death developed in 1 case (0.45%), now-Q wave MI in 1 case (0.45%). The patients were followed up to 15.6 +/- 12.3 months. Death developed in 12 cases (5.4%), including cardiac death in 10 cases (4.5%) and non-cardiac death in 2 cases (0.9%), MI in 4 cases (1.8%), TLR of LMCA in 26 cases (11.7%) and accumulated MACE in 36 cases (16.1%). LVEF < 40%, female and LMCA combined with multivessel disease increased mortality, combined multivessel diseases with incomplete revascularization increased MACE. Logistic regression analysis revealed that LVEF < 40% and female were independent predictors of cardiac death and MACE. Follow-up angiography was performed in 102 cases (45.7%). The binary restenosis rate was 31.4% (in 32 cases).


CONCLUSIONS
Stenting for selected patients with unprotected LMCA stenosis is feasible and safe. Currently, unprotected LMCA stenting should be performed in patients with LVEF >or= 40% and isolated LMCA disease or LMCA combined with multivessel diseases in whom complete revascularization could be obtained or inoperable patients.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult