title: Long-term clinical outcomes after unprotected left main coronary artery stenting in an all-comers patient population.
abstract: BACKGROUND
  The goal of treating patients with coronary artery disease is to improve survival and relieve symptoms. Several studies have compared the safety and efficacy of left main coronary artery (LMCA) stenting and coronary-artery bypass grafting in case control and randomized trials.
  
  
  OBJECTIVE
  In this study we present the long term outcome of stenting unprotected LMCA stenosis in day to day practice in unselected patients.
  
  
  METHODS
  One hundred and fifty eight patients were prospectively recruited with symptomatic unprotected LMCA stenosis undergoing percutaneous coronary intervention (PCI). Using the euroSCORE, each patient's surgical mortality risk was estimated. Study end-points were any major adverse cardiac event (MACE) defined as cardiac death, nonfatal myocardial infarction, or target lesion revascularization at follow-up with either CABG or repeat PCI.
  
  
  RESULTS
  The mean follow-up was 54 ± 25 months. The mean euroSCORE was 10.6 ± 13.4 (0.9-71) and the mean SYNTAX score was 39.6 ± 10.7 (10-65). The MACE rate was 11.4% at a mean follow up of 54 months. Six (3.8%) patients suffered postprocedure myocardial infarction. There were 24 (15%) deaths of which 12 were cardiac (mean euroSCORE 21.6 ± 5.5 P < 0.001). Repeat angiography was performed in 88 (55.7%) patients. Seven (4.4%) patients had in-stent restenosis; three occurred in BMS (P = 0.06). Two patients underwent revascularization with CABG and five had successful repeat PCI.
  
  
  CONCLUSIONS
  In this on-going registry of high risk patients with LMCA stenosis, stenting was found to be safe and clinically effective in maintaining event-free survival.
authors: Department of Cardiology, Beaumont Hospital, Ireland.
authors: Mohammed
authors: M
authors: Ali
authors: Alan
authors: A
authors: Hanley
authors: Brendan
authors: B
authors: McAdam
authors: Rory
authors: R
authors: O'Hanlon
authors: Thomas
authors: T
authors: Gumbrielle
authors: Richard
authors: R
authors: Sheahan
authors: David P
authors: DP
authors: Foley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology; D023921:Coronary Stenosis / Q000175:diagnosis / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: MACE; acute coronary syndrome; bare metal stents; drug eluting stents; euroSCORE; left main coronary artery percutaneous intervention