title: Two-year outcomes of everolimus vs. paclitaxel-eluting stent for the treatment of unprotected left main lesions: a propensity score matching comparison of patients included in the French Left Main Taxus (FLM Taxus) and the LEft MAin Xience (LEMAX) registries.
abstract: OBJECTIVE
  With newer drug-eluting stents (DES), PCI has appeared as an acceptable alternative to cardiac surgery in the treatment of unprotected left main (ULM) lesions. Using data from the French Left Main Taxus and the LEft MAin Xience registries, we compared two-year outcomes in consecutive patients from 2003-2008 using everolimus-eluting stents (EES) vs. paclitaxel-eluting stents (PES).
  
  
  RESULTS
  We performed a matched comparison according to SYNTAX score, distal LM stenosis, provisional side-branch T-stenting and single stent use, focusing on the primary endpoints of target vessel MI (TVMI) and target vessel failure (TVF). After propensity score matching, there were 172 patients in each group. There was no difference in gender (76.5% male), age (69.5 ± 11.3 years), diabetes (26.2% vs. 24.4%, p=0.71), NSTEMI (40.7% vs. 40.7%, p=1), or LVEF <40% (11.0% vs. 6.7%, p=0.22). Patients with distal LM lesions (75.9%) were treated using provisional T-stenting in 91.1%. The side branch was stented in 22% of all patients (p=0.51). Cumulative two-year events showed significant differences in TVMI (9.9% vs. 4.1%, p=0.04) and TVF (16.3% vs. 7.6%, p=0.01) for PES and EES, respectively.
  
  
  CONCLUSIONS
  ULM stenting with EES is safer and more effective than PES with a reduction in TLF by 53% at two years.
authors: Institut Jacques Cartier and Hopital Claude Galien, Institut Cardiovasculaire Paris Sud, Massy and Quincy, France.
authors: Anouska
authors: A
authors: Moynagh
authors: Neus
authors: N
authors: Salvatella
authors: Talal
authors: T
authors: Harb
authors: Olivier
authors: O
authors: Darremont
authors: Nicolas
authors: N
authors: Boudou
authors: Nicolas
authors: N
authors: Dumonteil
authors: Thierry
authors: T
authors: Lefèvre
authors: Didier
authors: D
authors: Carrié
authors: Yves
authors: Y
authors: Louvard
authors: Jean-Louis
authors: JL
authors: Leymarie
authors: Bernard
authors: B
authors: Chevalier
authors: Marie-Claude
authors: MC
authors: Morice
authors: Philippe
authors: P
authors: Garot
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006331:Heart Diseases / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D057216:Propensity Score; D012042:Registries; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus