title: Very long-term outcomes after percutaneous coronary intervention with bare metal stents for unprotected left main coronary artery disease.
abstract: OBJECTIVE
  The aim of this study was to evaluate very long-term clinical outcomes and potential predictors after percutaneous coronary intervention (PCI) with bare metal stents (BMS) for unprotected left main coronary artery disease (ULMCAD).
  
  
  RESULTS
  From March 1991 to August 2001, 151 patients who underwent PCI with BMS for ULMCAD were investigated retrospectively. The patient-oriented major adverse cardiac events (MACE) were defined as the occurrence of all-cause death, any MI, and any coronary revascularisation. The median follow-up duration was 10.5 years. The mean age was 69.9±11.5 years, and 106 patients (70.2%) were male. At 10 years, the incidences of cardiac death (CD), target lesion revascularisation (TLR) and patient-oriented MACE were 11.1%, 25.2% and 81.9%, respectively. In multivariate analysis, the pre-reference diameter of the left main trunk (LMT) was significantly associated with TLR (adjusted hazard ratio [HR] [95% confidence interval (CI)], 0.28 [0.14-0.54], p<0.001) and the SYNTAX score remained an independent predictor of patient-oriented MACE (adjusted HR [95% CI], 1.03 [1.007-1.05], p=0.009).
  
  
  CONCLUSIONS
  The pre-reference diameter of LMT was significantly associated with TLR, and the SYNTAX score significantly predicted the risk of patient-oriented MACE at 10 years. BMS implantation for larger size of ULMCAD with a lower SYNTAX score was feasible for up to 10 years.
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka. Japan. nomuryn@gmail.com
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nomura
authors.forename: Kyohei
authors.initials: K
authors.lastname: Yamaji
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shirai
authors.forename: Fumio
authors.initials: F
authors.lastname: Omata
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Michio
authors.initials: M
authors.lastname: Nagashima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Arita
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.forename: Koyu
authors.initials: K
authors.lastname: Sakai
authors.forename: Masahiko
authors.initials: M
authors.lastname: Goya
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Masashi
authors.initials: M
authors.lastname: Iwabuchi
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Nobuyoshi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D023921:Coronary Stenosis / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation / Q000401:mortality / Q000706:statistics & numerical data*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents / Q000706:statistics & numerical data*; D016896:Treatment Outcome