Longest available clinical outcomes after drug-eluting stent implantation for unprotected left main coronary artery disease: the DELFT (Drug Eluting stent for LeFT main) Registry.
OBJECTIVE
The purpose of this study was to investigate the long-term safety and efficacy of percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation for unprotected left main coronary artery (ULMCA) disease.


BACKGROUND
Long-term clinical outcomes after DES implantation for ULMCA disease have not yet been ascertained.


METHODS
From April 2002 to April 2004, 358 consecutive patients who underwent PCI with DES implantation for de novo lesions on ULMCA were retrospectively selected and analyzed in 7 European and U.S. tertiary care centers. No patients were excluded from the analysis, and all patients had a minimum follow-up of 3 years.


RESULTS
Technical success rate was 100%. Procedural success rate was 89.6%. After 3 years, major adverse cardiovascular events (MACE)-free survival in the whole population was 73.5%. According to the Academic Research Consortium definitions, cardiac death occurred in 9.2% of patients, and reinfarction, target lesion revascularization (TLR), and target vessel revascularization (TVR) occurred in 8.6%, 5.8%, and 14.2% of patients, respectively. Definite stent thrombosis occurred in 2 patients (specifically at 0 and 439 days). In elective patients, the 3-year MACE-free survival was 74.2%, with mortality, reinfarction, TLR, and TVR rates of 6.2%, 8.3%, 6.6%, and 16%, respectively. In the emergent group the 3-year MACE-free survival was 68.2%, with mortality, reinfarction, TLR, and TVR rates of 21.4%, 10%, 2.8%, and 7.1%, respectively.


CONCLUSIONS
Routine DES implantation in ULMCA disease seems encouraging, with favorable long-term clinical results.
Department of Interventional Cardiology, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands.
Emanuele
E
Meliga
Hector Manuel
HM
Garcia-Garcia
Marco
M
Valgimigli
Alaide
A
Chieffo
Giuseppe
G
Biondi-Zoccai
Andrew O
AO
Maree
Stephen
S
Cook
Lindsay
L
Reardon
Claudio
C
Moretti
Stefano
S
De Servi
Igor F
IF
Palacios
Stephen
S
Windecker
Antonio
A
Colombo
Ron
R
van Domburg
Imad
I
Sheiban
Patrick W
PW
Serruys
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors