Long-term mortality in patients unsuitable for surgical revascularization undergoing elective left main coronary artery angioplasty.
OBJECTIVE
Elective percutaneous coronary intervention (PCI) of left main coronary artery disease remains an important challenge in interventional cardiology. Nonetheless, this procedure is useful for patients with significant left main stenosis who are candidates for revascularization but unsuitable for coronary artery bypass graft. In this study the Authors sought to evaluate the safety and long-term mortality of PCI of left main coronary artery disease. Secondary endpoints were to analyse long-term mortality in various categories (patients<75 years vs patients<75 years, males vs females, drug eluting stents [DES] vs bare metal stents [BMS]).


METHODS
Between January 2003 and December 2006, 131 patients who consecutively under-went PCI on left main stem were reviewed. The mean follow-up time was 14.0+/-10.8 months. Survival curves were plotted with the Kaplan-Meier method and compared with the Log-rank test.


RESULTS
The Kaplan-Meier curves did not show statistically significant differences in terms of all-cause mortality at follow-up between protected and unprotected left main coronary disease (12% vs 14% respectively, P=0.67). In the protected left main group, there was a significantly higher use of DES compared with unprotected left main group (59% vs 43%, P=0.02).


CONCLUSIONS
The data show that PCI for left main coronary disease is feasible, safe and with an acceptable long-term mortality rate in patients at high-surgical risk unsuitable for surgical revascularization.
Vignali
L
L
Division of Cardiology, University Hospital of Parma, Parma, Italy. luvignali@ao.pr.it
Talanas
G
G
Menozzi
A
A
Cattabiani
M A
MA
Solinas
E
E
Aurier
E
E
Ardissino
D
D
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D054855:Drug-Eluting Stents; D017558:Elective Surgical Procedures / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D016019:Survival Analysis