Multicenter international registry of unprotected left main coronary artery percutaneous coronary intervention with everolimus-eluting stents.
OBJECTIVE
The aim of this study was to assess the clinical outcomes of percutaneous coronary intervention (PCI) with everolimus-eluting stents (EES) for the treatment of unprotected left main coronary artery (ULMCA) disease.


BACKGROUND
The standard of care for the treatment of ULMCA disease is coronary artery bypass grafting (CABG). Data suggest that PCI with drug-eluting stents is a viable alternative to CABG for the treatment of ULMCA disease. Randomized trials demonstrated superior event-free survival with EES compared with paclitaxel-eluting stents in non-ULMCA lesions. However, data with ULMCA PCI with EES are limited.


METHODS
This multicenter international registry included 178 patients from the United States, South Korea, and Italy who underwent ULMCA PCI with EES from 2008 to 2010. The primary endpoint was freedom from target lesion failure (TLF), defined as cardiac death, myocardial infarction (MI), and ischemia-driven target lesion revascularization (TLR) at 1 year.


RESULTS
At 30 days, 4 patients (2.2%) died from cardiac causes, and no patient experienced MI or TLR. One-year freedom from TLF was 94.4%. One-year freedom from cardiac death, MI, and ischemia-driven TLR was 96.6%, 98.9%, and 98.3%, respectively. Two patients (1.1%) had definite or probable stent thrombosis.


CONCLUSIONS
PCI with EES is safe and effective and may be a viable option for the treatment of ULMCA disease.
UCLA Medical Center, Los Angeles, CA, USA.
Michael S
MS
Lee
Kyung Woo
KW
Park
Si-Hyuck
SH
Kang
Imad
I
Sheiban
Ehtisham
E
Mahmud
Khalid Bin
KB
Thani
Richard
R
Cheng
Jang-Hyun
JH
Cho
Dong-Kyu
DK
Jin
Hyeon-Cheol
HC
Gwon
In-Ho
IH
Chae
Joseph
J
Aragon
Kyle
K
Gillis
Gregg W
GW
Stone
Hyo-Soo
HS
Kim
D000368:Aged; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007391:International Cooperation; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D012042:Registries; D012044:Regression Analysis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D000068338:Everolimus; D020123:Sirolimus