Sirolimus-Eluting Stents vs Bare Metal Stents for the treatment of unprotected left main coronary artery stenosis.
OBJECTIVE
This study compares the clinical and angiographic outcomes of sirolimus eluting stent (SES) and bare metal stent (BMS) implantation for unprotected left main coronary artery (ULMCA) stenosis.


RESULTS
We analysed 141 unselected patients with unprotected LMCA stenosis: 72 were treated with SES and 69 with BMS. SES patients were younger, with a higher ejection fraction, had more often hypertension, family history and were more often smokers. The procedural success rate was 94.2% in SES group and 87% in BMS group. In SES group there were 2 periprocedural myocardial infarction (3%). 1 intra-procedural death (1.4%) and 1 in-hospital death (1.4%) and respectively 2 (3%),4 (6%) and 3 (4%) in BMS group. No incidents of stent thrombosis, stroke and emergent CABG occurred during hospitalisation in either group. SES patients showed a lower late lumen loss (0.5+/-0.8 mm vs 1.1+/-1.0 mm; p<0.05) and a lower nine-month angiographic restenosis rate (13.6% vs 24.3%; p=NS). The MACE free survival rate at 2 years was 83% in the SES group vs 55% in the BMS group (p<0.001).


CONCLUSIONS
SES implantation for unprotected LMCA stenosis in "real world" population appears safe with a low restenosis and MACE rate at follow-up.
Sheiban
Imad
I
Interventional Cardiology, Division of Cardiology, University of Torino, San Giovanni Battista Hospital, Torino, Italy.
Meliga
Emanuele
E
Moretti
Claudio
C
Fumagalli
Alison
A
Omedè
Pierluigi
P
Sciuto
Filippo
F
Grossomarra
Walter
W
Trevi
Gianpaolo
G