Two-year outcomes of the sirolimus-eluting stent according to unprotected left main lesion.
BACKGROUND
The data of long-term outcomes of sirolimus-eluting stent (SES) according to lesion location of unprotected left main coronary artery (LMCA) is scarce.


OBJECTIVE
The purpose of this study was to evaluate the long-term outcomes after implantation of the SES in LMCA.


METHODS
A total of 84 patients (51 males) who had undergone SES implantation for the treatment of native LMCA stenosis were enrolled. The patients were divided into 2 groups based on angiographic lesion location: those with significant stenosis in the ostium and/or body (group 1; n = 39) and those involving bifurcation (group 2; n = 45).


RESULTS
All of the group 1 patients were treated with simple lesion coverage while different stenting techniques were used in group 2 (cross-over: 44.8%, T: 6.7%, kissing: 37.8%, and crush techniques: 11.1%). The 8-month quantitative angiographic findings and in-hospital and 2 year rates of major adverse cardiac events (MACE) were compared between the 2 groups. Although angiographic success and in-hospital MACE rates were similar in both groups with 1 cardiac death due to acute stent thrombosis in group 2, at 2-year follow-up, the MACE rate was significantly higher in group 2 than in group 1 at 2 years (22.2% vs 2.6%, respectively, P = 0.008). Coronary angiography revealed a significantly higher binary restenosis rate in group 2 compared with group 1 (20% vs 0%, respectively, P = 0.003).


CONCLUSIONS
Interventional treatment using SES in left main lesions showed favorable short-term and long-term outcomes in selected patients with lesion location being an important determinant of clinical and angiographic outcomes.
Kim
Ung
U
Cardiology Division, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, South Korea.
Park
Jong-Seon
JS
Seol
Sang-Hoon
SH
Yang
Tae-Hyun
TH
Kim
Sung-Man
SM
Kim
Dae-Kyung
DK
Kim
Doo-Il
DI
Kim
Dong-Soo
DS
Lee
Won-Jae
WJ
Lee
Sang-Hee
SH
Hong
Geu-Ru
GR
Shin
Dong-Gu
DG
Kim
Young-Jo
YJ
Shim
Bong-Sup
BS
Cho
Yoon-Kyung
YK
Kim
Hyung-Seop
HS
Nam
Chang-Wook
CW
Hur
Seung-Ho
SH
Kim
Kwon-Bae
KB
Kim
Yoon-Nyun
YN
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology / Q000517:prevention & control; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D020123:Sirolimus / Q000008:administration & dosage*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D020123:Sirolimus