title: Impact of acute coronary syndromes on two-year clinical outcomes in patients with unprotected left main coronary artery stenosis treated with drug-eluting stents.
abstract: In this study we investigated the impact of acute coronary syndromes (ACSs) on clinical outcomes in patients with unprotected left main coronary artery (ULMCA) stenosis treated with drug-eluting stents (DESs). In this multicenter, retrospective, observational study we enrolled 1,101 patients with ULMCA stenosis treated with DESs. Six hundred eleven patients presented with ACS and 490 had stable coronary artery disease. ACS was defined as the presence of unstable angina or non-ST-segment elevation myocardial infarction (MI). During 2-year follow-up, the adjusted hazard ratio of cardiac mortality and MI of patients with ACS versus stable patients was 2.42 (95% confidence interval 1.37 to 4.28, p = 0.002). We observed a stepwise risk increase, namely patients with stable coronary disease had the lowest risk, patients with unstable angina an intermediate risk, and patients with non-ST-segment elevation MI the highest risk. The increased risk of cardiac mortality and MI of patients with ACS was concentrated in the first year after DES implantation. In conclusion, patients with ULMCA stenosis and ACS treated with DESs have an increased risk of cardiac mortality and MI during the first year after the intervention compared to stable patients.
authors.affiliation: Istituto di Cardiologia, Policlinico S. Orsola, Università di Bologna, Bologna, Italy. tulliopalmerini@hotmail.com
authors.forename: Tullio
authors.initials: T
authors.lastname: Palmerini
authors.forename: Diego
authors.initials: D
authors.lastname: Sangiorgi
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Massimo
authors.initials: M
authors.lastname: Margheri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vecchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sangiorgi
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Franco
authors.forename: Antonio
authors.initials: A
authors.lastname: Bartorelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Briguori
authors.forename: Luigi
authors.initials: L
authors.lastname: Vignali
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Pede
authors.forename: Angelo
authors.initials: A
authors.lastname: Ramondo
authors.forename: Massimo
authors.initials: M
authors.lastname: Medda
authors.forename: Marco
authors.initials: M
authors.lastname: De Carlo
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bolognese
authors.forename: Alberto
authors.initials: A
authors.lastname: Benassi
authors.forename: Cataldo
authors.initials: C
authors.lastname: Palmieri
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Filippone
authors.forename: Giulia
authors.initials: G
authors.lastname: Lauria
authors.forename: Stefano
authors.initials: S
authors.lastname: De Servi
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D023921:Coronary Stenosis / Q000150:complications / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome