title: Early and long-term outcomes after percutaneous coronary intervention of unprotected left main coronary disease with drug-eluting stents in patients with non-ST-elevation acute coronary syndrome.
abstract: BACKGROUND
  Patients presenting with non-ST-elevation acute coronary syndrome (NSTE-ACS) and unprotected left main coronary disease (ULMCD) are among the highest risk patients but current consensus guidelines do not address the optimal timing and mode of revascularization for these individuals.
  
  
  METHODS
  In this single-centre registry, we evaluated the clinical outcomes of 151 consecutive patients with NSTE-ACS and ULMCD who underwent percutaneous coronary intervention with drug-eluting stents from 2005 to 2009.
  
  
  RESULTS
  Overall in-hospital major adverse cardiac event (MACE) rate was 5.3%, mortality rate was 0.7%. At 30 months±15 months, 30 patients (19.9%) experienced MACE. The 4-year cumulative survival rate of no MACE was 73.2% and cumulative survival rate was 90.6%. Left ventricular ejection fraction (hazard ratio [HR] 0.947; 95% confidence interval [CI], 0.898-0.998; P=0.043) and SYNTAX [SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery] score≥33 (HR 1.28; 95% CI, 1.025-1.433; P=0.029) were associated with MACE, while only left ventricular ejection fraction (HR 0.82; 95% CI, 0.69-0.973; P=0.023) was associated with mortality.
  
  
  CONCLUSIONS
  Our study demonstrates the feasibility of percutaneous coronary intervention with drug-eluting stents in patients with NSTE-ACS and ULMCD. The early and long-term outcomes were acceptable. Left ventricular ejection fraction and SYNTAX score≥33 predict MACE and only left ventricular ejection fraction predicts mortality.
authors.affiliation: Department of Cardiology, Provincial Hospital affiliated to Shandong University, Jinan, China.
authors.forename: Chuanyan
authors.initials: C
authors.lastname: Zhao
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Wu
authors.forename: Lianqun
authors.initials: L
authors.lastname: Cui
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome